Triglyceride-production rates in patients with type-4 hypertriglyceridaemia.

A new method has been devised to study triglyceride-production rates in man. The clearance of plasma-triglyceride transported on very-low-density lipoproteins (V.L.D.I.) to peripheral tissues is inhibited by about 50 percent with protamine sulphate; and this results in a rise of blood-glycerides over 1 hour. In a group of nine patients with type-IV hypertriglyceridaemia (mean fasting glycerides 252 mg. per 100 ml.) the mean increment of plasma-triglycerides was 29.8 compared with 1.4 mg. per 100 ml. per hour for nine controls whose mean fasting glycerides had been only 105 mg. per 100 ml. Patients with fasting plasma-triglycerides greater than 400 mg. per 100 ml. showed a response to protamine more like controls. It is suggested that patients with type-IV hyperlipaemia and fasting levels of triglycerides less than 400 mg. per 100 ml. are secreting triglycerides into blood at greater rates than controls; whereas patients with sever hypertriglyceridaemia (levels greater than 400 mg. per 100 ml.) may have a defect of triglyceride clearance so that inhibition by protamine produces no further change in level of plasma glycerides.