Postprandial Peaking and Plateauing of Triglycerides and VLDL in Patients with Underlying Cardiovascular Diseases Despite Treatment

AUTHORS

Clarissa E. E. Samson 1 , Ana Lyza B. B. Galia 1 , Khristine Ivy C. C. Llave 2 , Manuel B. B. Zacarias 3 , Leilani B. B. Mercado-Asis 1 , *

1 Section of Endocrinology and Metabolism, University Of Santo Tomas Hospital, [email protected], Philippines

2 Dietary Services, University of Santo Tomas Hospital, Philippines

3 Section of Cardiology, University of Santo Tomas Hospital, Philippines

How to Cite: Samson C E, Galia A L B, Llave K I C, Zacarias M B, Mercado-Asis L B. Postprandial Peaking and Plateauing of Triglycerides and VLDL in Patients with Underlying Cardiovascular Diseases Despite Treatment, Int J Endocrinol Metab. Online ahead of Print ; 10(4):587-593. doi: 10.5812/ijem.4783.

ARTICLE INFORMATION

International Journal of Endocrinology and Metabolism: 10 (4); 587-593
Published Online: September 29, 2012
Article Type: Original Article
Received: March 8, 2012
Accepted: May 23, 2012
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Abstract

Background: Dyslipidemia is associated with cardiovascular morbidities and mortality. Currently, fasting lipid profile determination is used to monitor treatment response. Recently, postprandial lipemia is of increasing interest because of its atherogenic and thrombogenic potential and also was found to be more predictive for cardiovascular diseases.

Objectives: To demonstrate postprandial lipemia among patients with cardiovascular diseases despite low fat diet, normal fasting lipid profile and even statin regimen.

Patients and Methods: Patients aged 40-80 years old with cardiovascular diseases (i.e. coronary artery disease and cerebrovascular disease) more than 6 months, on statin treatment for more than 6 months and normal fasting lipid profile (according to NCEP ATP III guidelines) were included. Study exclusion criteria were pregnancy, acute cardiovascular events < 6 months, hepatic or renal failure. Finally, twelve patients were included.

Results: The triglyceride level showed a significant rise from fasting to 2 hours after breakfast with a mean difference of 23.86 mg/dL (P =0.012). The level peaked at 4 hours after breakfast with a mean difference (MD) of 72.02 mg/dL (P =0.002). Subsequent triglyceride levels plateaued and were significantly higher than the baseline (P <0.05) until the 12th hour of observation. VLDL levels showed a similar pattern. Levels increased significantly from fasting to 2h after breakfast (mean difference: 4.49 mg/dL, P = 0.007), then plateaued and further increased 4 hours after breakfast (MD: 14.01 mg/dL, P = 0.002). VLDL levels were significantly higher than fasting (P < 0.05) and did not return to baseline until the 12th hour of observation. In contrast, the levels of total cholesterol, HDL and LDL decreased postprandially.

Conclusions: Triglyceride and VLDL peaking and plateauing were observed in patients with cardiovascular diseases despite low fat diet, normal fasting lipid profile and statin regimen. These findings may raise more attentions in monitoring and management of dyslipidemia in patients with cardiovascular and cerebrovascular events.

Keywords

Postprandial Lipemia Cardiovasular Disease Triglyceride VLDL

© 2012, International Journal of Endocrinology and Metabolism. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

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