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

Pablo Perez-Martinez, Juan F. Alcala-Diaz, Edmon K. Kabagambe, Antonio Garcia-Rios, Michael Y. Tsai, Javier Delgado-Lista, Genovefa Kolovou, Robert J. Straka, Francisco Gomez-Delgado, Paul N. Hopkins, Carmen Marin, Ingrid Borecki, Elena M. Yubero-Serrano, James E. Hixson, Antonio Camargo, Michael A. Province, Javier Lopez-Moreno, Fernando Rodriguez-Cantalejo, Francisco J. Tinahones, Dimitri P. MikhailidisFrancisco Perez-Jimenez, Donna K. Arnett, Jose M. Ordovas, Jose Lopez-Miranda

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

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).

Original languageEnglish (US)
Pages (from-to)1163-1171
Number of pages9
JournalJournal of Clinical Lipidology
Volume10
Issue number5
DOIs
StatePublished - Sep 1 2016

Bibliographical note

Funding Information:
The CORDIOPREV study is supported by the Fundacion Patrimonio Comunal Olivarero. We also received additional funding from CITOLIVA, CEAS, Junta de Andalucia (Consejeria de Salud, Consejeria de Agricultura y Pesca, Consejeria de Innovacion, Ciencia y Empresa), Diputaciones de Jaen y Cordoba, Centro de Excelencia en Investigacion sobre Aceite de Oliva y Salud, and Ministerio de Medio Ambiente, Medio Rural y Marino, Spanish Government. It was also partly supported by research grants from the Ministerio de Ciencia e Innovaci?n (AGL2009-122270 to Jose Lopez-Miranda, FIS PI13/00185 to Dr Perez-Martinez, FIS PI13/00023 to Dr Delgado-Lista); Ministerio de Econom?a y?Competitividad (AGL2012/39615 to Jose Lopez-Miranda); Proyecto de Excelencia, Consejer?a de Econom?a, Innovaci?n, Ciencia y Empleo (CVI-7450 to Jose Lopez-Miranda); by a Research Grant from the European Community (NUTRITECH European Integrated Project-289511). The GOLDN study was supported by NIH Heart,Lung and Blood Institute grant U 01 HL72524, Genetic and Environmental Determinants of Triglycerides. Dr Gomez-Delgado is supported by an ISCIII research contract (Programa Rio-Hortega). The CIBEROBN is an initiative of the Instituto de Salud Carlos III, Madrid, Spain.

Publisher Copyright:
© 2016 National Lipid Association

Keywords

  • CORDIOPREV study
  • Coronary heart disease
  • GOLDN study
  • Oral-fat tolerance test
  • Postprandial lipemia
  • Triglycerides

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