Effect of controlled alcohol feeding on triglycerides in patients with outpatient 'alcohol hypertriglyceridemia'

Hypertriglyceridemia in alcohol-consuming out-patients that abates after the discontinuation of alcohol is assumed to be caused by alcohol. It is unclear, however, whether this hypertriglyceridemia is the consequence of the energy-content of alcohol or of a specific stimulation of triglycericde production. To evaluate this question triglyceride levels and removal rate were studied before and after isocaloric replacement of food with alcohol under metabolic ward conditions. In paired studies, triglyceride concentrations and removal rate were decreased with alcohol in four out of six patients on a mixed diet and three out of four on a fat-free diet. The plasma triglyceride levels and removal rates increased in the other three patients. Since the changes in level and removal rate were concordant, alcohol probably affects production more than removal. In conclusion, alcohol can be shown to have a specific hypertriglyceridemic effect in only three out of ten patients with 'alcohol hypertriglyceridemia'. Isocaloric substitution of alcohol for food does lead to a decrease in triglyceride level in seven out of ten patients, who respond with a drop in triglycerides to ethanol withdrawal as out-patients.