Clinical Utility and Approach to Estimate Postprandial Hypertriglycemia by A Newly Designed Oral Fat-loading Test

Abstract

The objective of this study was to estimate postprandial hypertriglycemia by a newly designed oral fat-loading test. Twenty-three healthy normolipidemic volunteers were orally administered a test meal consisting of a mixture of Telmeal 2.0  and 20 g of saltfree butter after fasting for 12 h. To measure the levels of total cholesterol (T-Cho), triglycerides (TG), high-density lipoprotein-cholesterol (HDL-C), remnant-like particlecholesterol (RLP-C), lipoprotein (a) [Lp (a)], free fatty acid, apolipoproteins (Apos), plasma glucose (PG), immunoreactive insulin (IRI), and high-sensitivity C-reactive protein (hs-CRP), venous blood samples were collected before the meal and at each hour until 9 h after fat-loading. The levels of both TG and RLP-C were drastically elevated at 2 h after fat-loading and these levels remained high until 4 h ( p < 0.01). A significant correlation between TG and RLP-C was also observed at 2, 3 and 4 h, and the values of the correlation coefficients (r) were 0.837, 0.838, and 0.908, respectively. In contrast, the levels of T-Cho, HDL-C, Lp (a), Apos, PG, and hs-CRP did not change. Furthermore, there were no gastrointestinal symptoms during or after the study. These results strongly suggested that this newly designed fat-loading test was very useful for evaluating postprandial hypertriglycemia, including remnant concentrations. IntroductionMultiple epidemiological and clinical studies have established that dyslipidemia, e.g., increased total cholesterol (T-Cho), particularly low-density lipoprotein-cholesterol (LDL-C), and decreased high-density lipoproteincholesterol (HDL-C), is the most crucial factor in the pathogenesis of atherosclerosis, including coronary heart disease (CHD) and subsequent sudden death (1-5). In contrast, although some investigators have reported that moderately elevated fasting triglycerides (TG) increased coronary events (6-9), the independent role of TG in the contribution of CHD has been controversial, since the fasting level of TG is inversely related to that of HDL-C in lipid metabolism (10). Most studies on the relationship between atherosclerosis and lipids have been based on fasting lipid levels.Recently, however, some prospective studies have clearly shown the potential importance of postprandial hypertriglycemia in the etiology of CHD even after adjusting for HDL-C using multivariate analyses (11,12 A Newly Designed Oral Fat-loading Test TG level could predict the incidence of CHD, even in Japanese subjects who showed a decreased level of T-Cho, followed over a 15.5-year period (11). Talmud et al. have also suggested that the combined evaluation of apolipoprotein (Apo) B with nonfasting TG could provide useful diagnostic criteria for CHD risk (12). In addition, considerable evidence supports the view that postprandial hypertriglycemia is associated with insulin resistance, its concomitant compensatory hyperinsulinemia, and obesity (13,14).In contrast, although several investigators have tried and reported fat-loading tests to examine postprandial hypertrigl...

Acute metabolic responses to butter, margarine, and a monoglyceride gel-structured spread

“…Serum hs-CRP was not significantly altered by the meal ingestion and there were no differences across trials in the hs-CRP values or AUC (data not shown). This is similar to previous studies examining acute postprandial responses of hs-CRP in humans (Blackburn et al, 2006;Igarashi et al, 2003;Rush et al, 2008).…”

Development of Cookie Test for the Simultaneous Determination of Glucose Intolerance, Hyperinsulinemia, Insulin Resistance and Postprandial Dyslipidemia

“…Fat loading tests (20-45 g fat) have also been reported for the evaluation of postprandial hypertriglyceridemia or RLP [19,20]. An oral triglyceride tolerance drink has been reported, which contains 50 g fat and 50 g carbohydrate for the efficient monitoring of TG lowering therapies with additional information concerning cardiovascular disease risk [21].…”

Influence of Aging and Menopause on Postprandial Lipoprotein Responses in Healthy Adult Women

“…The loading dose has also never been standardized. The loading dose has been determined mainly in three ways in most studies: a fixed dose of fat 45) , fat weight per body surface area 9) and fat weight per body weight 46) . The fixed amount of fat method is too simple, because the difference between young and old, the differences between men and women, and differences in physique are not taken into account.…”