INFLUENCE OF OBESITY ON PLASMA-LIPOPROTEINS, GLYCEMIA AND INSULINEMIAIN PATIENTS WITH FAMILIAL COMBINED HYPERLIPIDEMIA

The influence of obesity on blood pressure and plasma lipoproteins, gl ucose and insulin levels was investigated in patients with familial co mbined hyperlipidaemia (FCH), Sixty seven FCH patients mean age 49.0 /- 8.9 y (45 male, 22 female) defined as obese (BMI greater than or eq ual to 27 kg/m(2), n = 39) or non-obese (BMI < 27 kg/m(2), n = 28) wer e compared with control subjects matched for age, gender and body weig ht. Blood pressure, plasma lipoproteins, glucose and insulin were meas ured at baseline and following standard oral glucose load. The analysi s indicate that FCH subjects with BMI greater than or equal to 27kg/m( 2) had significantly higher systolic and diastolic blood pressure, blo od glucose and insulin levels following oral glucose tolerance test th an those with BMl<27kg/m(2), Fasting plasma insulin values were also s ignificantly higher in the BMI greater than or equal to 27 kg/m(2) sub jects (138.5 +/- 66.6 vs 111.0 +/- 29.9 pmol/l, respectively, P < 0.05 ). Quantification of the area under the curve of the insulin secretion showed hyperinsulinaemia in 64.1% of patients with BMI greater than o r equal to 27 kg/m(2) compared to 28.5% in the group with BMI < 27 kg/ m(2) (P < 0.01). Plasma insulin values were positively related to trig lyceridaemia. There were no differences in the plasma lipid values bet ween the two FCH groups. We conclude that fasting and post-glucose sti mulated plasma insulin levels are frequent findings in patients with F GH when compared with control subjects of similar age, gender and BMI. Moreover, obesity (BMI greater than or equal to 27 kg/m(2)) exacerbat es the hyperglycaemia, hyperinsulinaemia and blood pressure values in these FCH subjects. These factors, together with lipid abnormalities, can predispose to the elevated risk of cardiovascular disease observed in FCH subjects.