Elimination of fat emulsion particles from plasma during glucose infusion

Abstract

To determine the optimal rate of infusion of a fat emulsion (long-chain triglycerides; LCTs) for parenteral nutrition, the rate of elimination of triglycerides from plasma was measured on two occasions in three healthy subjects, once while receiving LCTs alone (study 1) and once while receiving a combined infusion of glucose and LCTs (study 2). In study 1 a hypertriglyceridaemic clamp was set up by raising the concentration of triglycerides to 2 mmol l-1 (60-min priming infusion at 0.2 g LCTs per kg body-weight per h) and maintaining this value for 300 min. In study 2 a constant infusion of glucose at a rate of 0.32 g per kg body-weight per h was given throughout the 420-min test, and the hypertriglyceridaemic clamp was set up after 70 min. The infusion of glucose induced a progressive increase in the mean (s.d.) concentration of insulin from 4.3 (0.4) μU ml-1 to a plateau value of 11.0 (0.2) μU ml-1 which was sustained during the last 310 min of the study. During the steady state of the hypertriglyceridaemic clamp, the concentration of triglycerides (2.16 (0.17) versus 2.12 (0.20) mmol l-1, P = 0.26), as well as the mean (s.d.) rates of infusion of LCTs (0.12 (0.08) versus 0.12 (0.04) per kg body-weight per h, P = 0.38), did not differ between studies 1 and 2. Thus, an infusion of glucose (and the associated physiological increase in the concentration of insulin) at doses commonly used in parenteral nutrition does not influence the rate of elimination of triglycerides from plasma in normal subjects.