LIPEMIA: CARBOHYDRATE AND GLYCERIDE METABOLISM

本子项目是利用由NIH/NCRR资助的中心赠款提供的资源的众多研究子项目之一。子项目和研究者（PI）可能已经从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。列出的机构是中心的，不一定是研究者的机构。美国国立卫生研究院最近发布了一项共识会议的结果，该会议敦促“所有美国人”食用低脂肪高碳水化合物的饮食。我们研究小组之前的研究结果表明，正常个体或非胰岛素依赖型糖尿病患者摄入低脂肪-高碳水化合物饮食可导致血浆葡萄糖、胰岛素、甘油三酯（TG）浓度升高，血浆高密度脂蛋白（LDL）浓度下降。由于患冠状动脉疾病（CAD）的风险已被证明与所有这些代谢变化有关，因此，“所有美国人”都吃低脂肪/高碳水化合物饮食的建议是否适当就会受到质疑。最近的观察表明，未经治疗的高血压患者的血糖、胰岛素和TG浓度高于正常水平。几种形式的抗过敏药物治疗已被证明会加重这些代谢缺陷以及降低血浆高密度脂蛋白胆固醇浓度。事实上，这些代谢异常的存在可以解释为什么高血压治疗并没有降低冠状动脉疾病的风险。鉴于上述代谢缺陷的存在，以及低脂/高碳水化合物饮食会加剧这些变化的事实，有必要提出这样一种可能性，即推荐的饮食改变可能会增加，而不是降低高血压患者患冠心病的风险。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The NIH has recently distributed the results of a consensus conference, which urges that "all Americans" consume low fat-high carbohydrate diets. Previous results from our research group have demonstrated that the ingestion of low fat-high carbohydrate diets by normal individuals or patients with non-insulin-dependent diabetes can lead to an increase in plasma concentrations of glucose, insulin, triglyceride (TG), as well as a fall in both plasma high density lipoprotein (LDL) concentrations. Since the risk of developing coronary artery disease (CAD) has been shown to be associated with all of these metabolic changes, questions can be raised as to the appropriateness of the advice that "all Americans" eat low fat/high carbohydrate diets. Recent observations have shown that patients with untreated hypertension have higher than normal plasma glucose, insulin and TG concentrations. Institution of several forms of anti-hypersensitive drug therapies have been shown to accentuate these metabolic defects as well as lower plasma HDL-cholesterol concentration. Indeed, the presence of these metabolic abnormalities may explain why treatment of hypertension has not reduced the risk of coronary artery disease. Given the presence of the metabolic defects outlined above, and the fact that these same changes are aggravated by low fat/high carbohydrate diets, it is necessary to raise the possibility that the recommended dietary change may increase, not decrease, the risk of CAD in patients with hypertension.