Assessment of postprandial triglycerides in clinical practice: Validation in a general population and coronary heart disease patients.

Perez-Martinez P, Alcala-Diaz JF, Kabagambe EK, Garcia-Rios A, Tsai MY, Delgado-Lista J, Kolovou G, Straka RJ, Gomez-Delgado F, Hopkins PN, Marin C, Borecki I, Yubero-Serrano EM, Hixson JE, Camargo A, Province MA, Lopez-Moreno J, Rodriguez-Cantalejo F, Tinahones FJ, Mikhailidis DP, Perez-Jimenez F, Arnett DK, Ordovas JM, Lopez-Miranda J
J Clin Lipidol. 2016 10 (5): 1163-71

PMID: 27678433 · DOI:10.1016/j.jacl.2016.05.009

BACKGROUND - Previous studies have suggested that for clinical purposes, subjects with fasting triglycerides (TGs) between 89-180 mg/dl (1-2 mmol/l) would benefit from postprandial TGs testing.

OBJECTIVE - To determine the postprandial TG response in 2 independent studies and validate who should benefit diagnostically from an oral-fat tolerance test (OFTT) in clinical practice.

METHODS - A population of 1002 patients with coronary heart disease (CHD) from the CORDIOPREV clinical trial and 1115 white US subjects from the GOLDN study underwent OFTTs. Subjects were classified into 3 groups according to fasting cut points of TGs to predict the usefulness of OFTT: (1) TG < 89 mg/dl (<1 mmol/l); (2) TG, 89-180 mg/dl (1-2 mmol/l); and (3) TG > 180 mg/dl (>2 mmol/l). Postprandial TG concentration at any point > 220 mg/dl (>2.5 mmol/l) has been pre-established as an undesirable postprandial response.

RESULTS - Of the total, 49% patients with CHD and 42% from the general population showed an undesirable response after the OFTT. The prevalence of undesirable postprandial TG in the CORDIOPREV clinical trial was 12.8, 50.3, and 89.7%, in group 1, 2, and 3, respectively (P < .001) and 11.2, 58.1, and 97.5% in group 1, 2, and 3, respectively (P < .001) in the GOLDN study.

CONCLUSIONS - These two studies validate the predictive values reported in a previous consensus. Moreover, the findings of the CORDIOPREV and GOLDN studies show that an OFTT is useful to identify postprandial hyperlipidemia in subjects with fasting TG between 1-2 mmol/l (89-180 mg/dL), because approximately half of them have hidden postprandial hyperlipidemia, which may influence treatment. An OFTT does not provide additional information regarding postprandial hyperlipidemia in subjects with low TG (<1 mmol/l, <89 mg/dL) or increased TG (>2 mmol/l, >180 mg/dl).

Copyright © 2016 National Lipid Association. Published by Elsevier Inc. All rights reserved.

MeSH Terms (15)

Adult Aged Age Factors Coronary Artery Disease Dietary Fats Female Humans Hyperlipidemias Logistic Models Male Middle Aged Odds Ratio Postprandial Period Prevalence Triglycerides

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