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).
Bibliographical noteFunding 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.
© 2016 National Lipid Association
- CORDIOPREV study
- Coronary heart disease
- GOLDN study
- Oral-fat tolerance test
- Postprandial lipemia