Postprandial dyslipidemia after a standardized high-fat meal in BMI-matched healthy individuals, and in subjects with prediabetes or type 2 diabetes

• Published in: Clinical nutrition (Edinburgh, Scotland) Vol. 40; no. 11; pp. 5538 - 5546
• Main Authors: Lim, Soo, Kim, Yoon Ji, Khang, Ah Reum, Eckel, Robert H.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.11.2021
• Subjects: Adult; Apolipoprotein B; Apolipoprotein B100; Apolipoprotein B48; atherosclerosis; Blood Glucose - drug effects; blood lipids; Body Mass Index; calorimetry; carotid arteries; Case-Control Studies; clinical nutrition; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - complications; Diet, High-Fat - adverse effects; Dietary Fats - adverse effects; dual-energy X-ray absorptiometry; Dyslipidemias - blood; Dyslipidemias - etiology; Fat meal; Female; glucose; glucose tolerance; high density lipoprotein cholesterol; high fat foods; Homeostasis; Humans; hyperlipidemia; insulin; Lipids - blood; low density lipoprotein cholesterol; Male; Meals; noninsulin-dependent diabetes mellitus; obesity; Postprandial Period - physiology; Prediabetic State - blood; Prediabetic State - complications; Triglycerides; visceral fat; Apolipoprotein B; Triglycerides; Apolipoprotein B100; Fat meal; Apolipoprotein B48
• ISSN: 0261-5614; 1532-1983; 1532-1983
• DOI: 10.1016/j.clnu.2021.09.004

A relationship between postprandial hyperlipidemia and glucose homeostasis/cardiovascular diseases has been suggested. We investigated postprandial plasma lipid patterns after a standardized high-fat meal and their association with glucose homeostasis and subclinical atherosclerosis. Using matching by BMI, 32 healthy individuals with normal glucose tolerance (NGT), 21 subjects with impaired glucose tolerance (IGT), and 20 subjects with drug-naïve type 2 diabetes (T2D) were enrolled. Plasma concentrations of triglycerides (TGs), apolipoprotein-B (ApoB), ApoB48, ApoB100, glucose, and insulin at baseline and 1, 2, 3, 4, 5, 6, and 8 h after a standardized meal (1041.03 kcal with 70.99 g of fat) were measured. Body composition, abdominal visceral fat area, and resting energy expenditure (REE) were measured using dual energy X-ray absorptiometry, computed tomography, and indirect calorimetry, respectively. The intima-media thickness (IMT) of the carotid artery and the ankle–brachial index (ABI) were used to detect subclinical atherosclerosis. Baseline data and area under the curve (AUC) of plasma concentrations of TGs, ApoB, and ApoB48 in the IGT and T2D groups were higher than in the NGT group. The peak TG concentrations after the meal was observed at 5 h in subjects with IGT and T2D, while healthy subjects showed the highest concentrations at 4 h. In multivariable analysis, high abdominal visceral fat area and low HDL-cholesterol concentrations were independently associated with the AUCTG and AUCApoB after adjusting for confounders including baseline TG and the REE. High LDL-cholesterol and high HbA1c concentrations were also associated with the AUCApoB. Furthermore, high AUCTG and AUCApoB values were independent factors for an increased carotid IMT and a low ABI after adjusting for relevant variables. Abdominal visceral obesity and low HDL-cholesterol concentrations were associated with increased post load excursions of TGs and ApoB in this series. These elevated concentrations of TGs and ApoB were linked with subclinical atherosclerosis.