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Type IV HyperlipoproteinemiaA Critical Appraisal
Gustav Schonfeld, MD;
David J. Kudzma, MD
Arch Intern Med. 1973;132(1):55-62.
Abstract
Sensitivity to carbohydrate, obesity, glucose intolerance, and hyperinsulinism have been separately assigned causative roles in primary type IV hyperlipoproteinemia. These conditions were inconstant enough in 18 consecutive men with type IV disease as to suggest that none is fundamental to the disorder. Endogenous triglyceridemia increased variably with carbohydrate surfeit, disappeared rarely with carbohydrate restriction, and showed imposing contributions from fed fat—findings indicating that the disorder is not necessarily carbohydrate-dependent. Levels of endogenous triglyceride before and after high-carbohydrate feeding lacked correlation with obesity, found in only 44% of the patients. Glucose intolerance occurred in 50%; hyperinsulinism occurred more regularly (seven of nine patients studied). As none of these conditions is common to all cases of type IV disease, it is likely that they play only contributory roles, intensifying the fundamental abnormality, or that the type IV phenotype has protean causes.
Author Affiliations
St. Louis; San Antonio, Tex
From the Department of Medicine, Washington University School of Medicine, St. Louis (Dr. Schonfeld), and Wilford Hall, USAF Medical Center, and the University of Texas Medical School at San Antonio, San Antonio, Tex.
Footnotes
Received for publication April 25, 1972; accepted May 4.
Reprint requests to Section of Endocrinology and Metabolism, Department of Medicine, University of Texas Medical School at San Antonio, 7703 Floyd Curl Dr, San Antonio TX 78284 (Dr. Kudzma).
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ABSTRACT
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