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La risposta insulinemica dopo carico orale di glucosio e tolbutamide I.V. in pazienti con iperlipemia «da grassi» e «da carboidrati»

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Riassunto

Gli AA. hanno studiato il comportamento della glicemia, dell'insulinemia sierica e dei NEFA plasmatici in 11 pazienti affetti da iperlipemia «da grassi» e «da carboidrati».

E' stato osservato che, mentre nell'iperlipemia «da grassi» non sono presenti alterazioni del metabolismo glucidico, nella varietà «da carboidrati» esiste una diminuita tolleranza agli zuccheri con elevati livelli di insulinemia circolante.

L'iperinsulinismo, presente nei pazienti iperlipemici con normale o subnormale tolleranza al carico orale di glucosio, suggerisce l'esistenza di una condizione di resistenza all'insulina.

Resume

Les AA. ont etudié le comportement de la glycémie, de l'insulinémie sérique et des NEFA plasmatiques en 11 sujets atteints de hyperlipémie «de lipides» et «de carbohydrates».

On a observé que, tandis que dans l'hyperlipémie «de lipides» il n'y a aucune altération du métabolisme glucidique, dans le type «de carbohydrate» il y a une moindre tolérabilité au glucose avec des niveaux élevés de insulinémie circulante.

L'hyperinsulinisme, présent dans les sujets hyperlipémiques avec une tolérabilité au charge du glucoseper os normale ou subnormale, fait naitre l'hypothèse d'une condition de résistence à l'insuline.

Resumen

Los AA. estudiaron el comportamiento de la glicemia, de la insulinemia sérica y de los NEFA plasmáticos en 11 pacientes afectos de hiperlipemia «por grasas» y «por carbohidratos».

Se observó que, mientras en la hiperlipemia «por grasas» no están presentes alteraciones del metabolismo glucídico, en la variedad «por carbohidratos» existe una menor tolerancia a los azúcares con elevados niveles de insulinemia circulante.

El hiperinsulinismo, presente en los enfermos hiperlipémicos con una normal o subnormal tolerancia a la carga oral de glucosa, sugiere la existencia de un estado de resistencia a la insulina.

Zusammenfassung

Die AA. untersuchten das Verhalten des Blutzuckers, der Insulinaemie im Serum, sowie der Plasma-NEFA bei 11 Patienten mit «Fett»- und «Kohlenhydrat»-Hyperlipaemie.

Es wurde beobachtet, dass bei der «Fett»-Hyperlipaemie keine Veraenderungen des Zuckerstoffwechsels bestehen, waehrend bei der «Kohlenhydrat»-Form eine verminderte Toleranz gegenueber den Kohlenhydraten mit hohen Spiegeln von zirkulierender Insulin anwesend ist.

Der bei hyperlipaemischen Patienten mit normaler oder subnormaler Toleranz gegenueber oraler Glukosebelastung bestehende Hyperinsulinismus laesst an das Vorhandensein einer Insulinresistenz denken.

Summary

The AA. have studied the behaviour of blood sugar, serum insulin, and plasma NEFA in 11 patients with «fat-induced» and «carbohydrate-induced» hyperlipemia.

It has been observed that, while in «fat-induced hyperlipemia» there are no evident abnormalities in glucose metabolism, in the «carbohydrate-induced» a decreased carbohydrate tolerance with elevated levels of circulating insulin has been shown.

High serum insulin levels in hyperlipemic patients with normal or subnormal glucose tolerance suggest the existence of insulin resistance.

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Authors and Affiliations

  1. Clinica Medica Generale dell'Universita' di Padova, Italy

    Antonio Tiengo, Gaetano Crepaldi, Michele Muggeo, Piero Avogaro, Giuliano Enzi, Alberto Trisotto & Giovanni Federspil

  2. Istituto di Semeiotica Medica dell'Universita' di Padova, 35100, Padova, Italy

    Antonio Tiengo, Gaetano Crepaldi, Michele Muggeo, Piero Avogaro, Giuliano Enzi, Alberto Trisotto & Giovanni Federspil

  3. Via Aosta, 14, 35100, Padova, Italy

    Antonio Tiengo

  4. Via Palermo, 21, 35100, Padova, Italy

    Gaetano Crepaldi

  5. Via Belzoni, 35100, Padova, Italy

    Michele Muggeo

  6. Via Altinate, 16, 35100, Padova, Italy

    Piero Avogaro

  7. Via Vesalio, 6, 35100, Padova, Italy

    Giuliano Enzi

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  1. Antonio Tiengo
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  2. Gaetano Crepaldi
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  3. Michele Muggeo
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  4. Piero Avogaro
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  5. Giuliano Enzi
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  6. Alberto Trisotto
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  7. Giovanni Federspil
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Tiengo, A., Crepaldi, G., Muggeo, M. et al. La risposta insulinemica dopo carico orale di glucosio e tolbutamide I.V. in pazienti con iperlipemia «da grassi» e «da carboidrati». Acta diabet. lat 4, 591–610 (1967). https://doi.org/10.1007/BF01544101

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