An Expert Panel group of scientists and clinicians met to consider several aspects related to non-fasting and postprandial triglycerides (TGs) and their role as risk factors for cardiovascular ...disease (CVD). In this context, we review recent epidemiological studies relevant to elevated non-fasting TGs as a risk factor for CVD and provide a suggested classification of non-fasting TG concentration. Secondly, we sought to describe methodologies to evaluate postprandial TG using a fat tolerance test (FTT) in the clinic. Thirdly, we discuss the role of non-fasting lipids in the treatment of postprandial hyperlipemia. Finally, we provide a series of clinical recommendations relating to non-fasting TGs based on the consensus of the Expert Panel: 1). Elevated non-fasting TGs are a risk factor for CVD. 2). The desirable non-fasting TG concentration is <2 mmol/l (<180 mg/dl). 3). For standardized postprandial testing, a single FTT meal should be given after an 8 h fast and should consist of 75 g of fat, 25 g of carbohydrates and 10 g of protein. 4). A single TG measurement 4 h after a FTT meal provides a good evaluation of the postprandial TG response. 5). Preferably, subjects with non-fasting TG levels of 1-2 mmol/l (89-180 mg/dl) should be tested with a FTT. 6). TG concentration ≤ 2.5 mmol/l (220 mg/dl) at any time after a FTT meal should be considered as a desirable postprandial TG response. 7). A higher and undesirable postprandial TG response could be treated by aggressive lifestyle modification (including nutritional supplementation) and/or TG lowering drugs like statins, fibrates and nicotinic acid.
Residual vascular risk exists despite the aggressive lowering of Low-Density Lipoprotein Cholesterol (LDL-C). A contributor to this residual risk may be elevated fasting, or non-fasting, levels of ...Triglyceride (TG)-rich lipoproteins. Therefore, there is a need to establish whethe a standardised Oral Fat Tolerance Test (OFTT) can improve atherosclerotic Cardiovascular (CV) Disease (ASCVD) risk prediction in addition to a fasting or non-fasting lipid profile. An expert panel considered the role of postprandial hypertriglyceridaemia (as represented by an OFTT) in predicting ASCVD. The panel updated its 2011 statement by considering new studies and various patient categories. The recommendations are based on expert opinion since no strict endpoint trials have been performed. Individuals with fasting TG concentration <1 mmol/L (89 mg/dL) commonly do not have an abnormal response to an OFTT. In contrast, those with fasting TG concentration ≥2 mmol/L (175 mg/dL) or nonfasting ≥2.3 mmol/L (200 mg/dL) will usually have an abnormal response. We recommend considering postprandial hypertriglyceridaemia testing when fasting TG concentrations and non-fasting TG concentrations are 1-2 mmol/L (89-175 mg/dL) and 1.3-2.3 mmol/L (115-200 mg/dL), respectively as an additional investigation for metabolic risk prediction along with other risk factors (obesity, current tobacco abuse, metabolic syndrome, hypertension, and diabetes mellitus). The panel proposes that an abnormal TG response to an OFTT (consisting of 75 g fat, 25 g carbohydrate and 10 g proteins) is >2.5 mmol/L (220 mg/dL). Postprandial hypertriglyceridaemia is an emerging factor that may contribute to residual CV risk. This possibility requires further research. A standardised OFTT will allow comparisons between investigational studies. We acknowledge that the OFTT will be mainly used for research to further clarify the role of TG in relation to CV risk. For routine practice, there is a considerable support for the use of a single non-fasting sample.
Triglycerides (TGs) are measured in studies evaluating changes in non-fasting lipid profiles after a fat tolerance test (FTT); however, the optimal timing for TG measurements after the oral fat load ...is unclear. The aim of this study was to evaluate how non-fasting TG levels vary after an oral FTT in healthy subjects.
This meta-analysis included 113 studies with >5 participants of Caucasian race that were indexed in PubMed from its inception through March 2010, using the search term "postprandial lipemia". We only included studies that provided mean values and standard deviation (SD) (or standard error of the mean) for TG measurements at baseline (=fasting) and for at least one other time-point. Exclusion criteria included uncommon sampling time-points after the FTT, baseline TGs≥2.0 mmol/L (≥177mg/dl), and a body mass index ≥30kg/m(2).
All studies combined, weighted mean±SD TG values in mmol/L were 1.25±0.32 fasting, 1.82±0.40 at 2 h, 2.31±0.62 at 4 h, 1.87±0.63 at 6 h, and 1.69±0.80 at 8 h. After stratifying studies based on fat quantity in the test meal (<40, ≥40-<50, ≥50-<60, ≥60-<70, ≥70-<80, ≥80-<90, ≥90-<100, ≥100-<110, ≥110-120, ≥120 g), the highest standardized mean difference in TG levels from fasting levels was found in those having an oral fat load of ≥70 g and <80 g, and at 4 h (difference=1.74 mmol/L; p<0.001).
The 4 h time-point after an oral fat load during a FTT was the most representative measurement of TGs. The highest standardized mean difference of TGs was found after a meal containing 70-79g of fat. The relevance of these two key parameters determined in healthy subjects should be considered for further developments of an oral FFT for clinical purposes.
Postprandial hypertriglyceridaemia, defined as an increase in plasma triglyceride-containing lipoproteins following a fat meal, is a potential risk predictor of atherosclerotic cardiovascular disease ...and other chronic diseases. Several non-modifiable factors (genetics, age, sex and menopausal status) and lifestyle factors (diet, physical activity, smoking status, obesity, alcohol and medication use) may influence postprandial hypertriglyceridaemia. This narrative review considers the studies published over the last decade that evaluated postprandial hypertriglyceridaemia. Additionally, the genetic determinants of postprandial plasma triglyceride levels, the types of meals for studying postprandial triglyceride response, and underlying conditions (e.g. familial dyslipidaemias, diabetes mellitus, metabolic syndrome, non-alcoholic fatty liver and chronic kidney disease) that are associated with postprandial hypertriglyceridaemia are reviewed; therapeutic aspects are also considered.
The actions of endogenous estrogens on the cardiovascular system can be mediated directly on the vessels or indirectly through the modulation of cardiovascular risk factors. Aging and menopause are ...the main causes that lead to an adverse lipid profile in women. The influence of age on prevalence of increased plasma triglyceride levels and on larger variation in fasting triglyceride levels has been reported in both genders. However, the increased prevalence of increased cholesterol with age was only found in women. The high-density lipid cholesterol level is higher in women than in men throughout all ages. Obesity may also exaggerate the unfavorable lipid profile in aging and/or menopausal women. In the last decades the management of the menopausal women has been a subject of concern for medical scientific groups. In this review, the current understanding of an influence of age and menopause on lipids and lipoproteins concentration in women will be analyzed.
Definition of postprandial lipaemia Kolovou, Genovefa D; Mikhailidis, Dimitri P; Nordestgaard, Børge G ...
Current vascular pharmacology,
05/2011, Letnik:
9, Številka:
3
Journal Article
At the present time, there is no widely agreed definition of postprandial lipaemia (PPL). This lack of a shared definition limits the identification and treatment of patients with exaggerated PPL as ...well as the evaluation of potential therapeutic agents. PPL is a complex syndrome characterized by non-fasting hypertriglyceridaemia that is associated with an increased risk of vascular events. This review considers the definition of PPL and the methodology for assessing this process.
Genetic factors contribute to the variation of human life span which is believed to be more profound after 85 years of age. The aim of the present study was to evaluate the frequency of 5 gene ...polymorphisms between nonagenarians, centenarians and average individuals.
Single nucleotide polymorphisms (SNPs) of telomerase reverse transcriptase (
; rs2736098), insulin-like growth factor-1 binding protein-3 (
; A-202C, rs2857744), fork-head box O3A (
; rs13217795 and rs2764264) factor and adiponectin (
; rs2241766) were evaluated in 405 individuals:
= 256 nonagenarians and centenarians (study group) and
= 149 average lifespan individuals (control group aged 18 - < 80 years).
The frequency of women was significantly higher in the study group than the control group (64.5 vs. 49.7%,
= 0.004). Genotypic and allele frequencies did not differ between groups according to gender. However, in men, the frequency of
genotype of
; rs2764264 was higher in the study group than the control group (45.6 vs. 28.0%,
= 0.05). Overall, the frequency of the
allele of
; rs2764264 was significantly lower in the study group than the control group (3.9 vs. 9.5%, respectively,
= 0.023). Furthermore, in the study group, the
allele was significantly more frequent in the nonagenarians (
= 239) than the centenarians (
= 17) in both
; rs13217795 and rs2764264 (64.4 vs. 44.1%,
= 0.018 and 69.7 vs. 50.0%,
= 0.017, respectively).
According to survival status, there is differentiation in the prevalence of both studied
gene polymorphisms. The study group had half of the
alleles compared with the control group and centenarians less frequently had the
allele of both
gene polymorphisms compared with nonagenarians. No difference was found between groups according to
,
and
gene polymorphisms. It seems that some polymorphisms may be significant in prolonging our lifespan. Nevertheless, confirmation in additional study populations is needed.
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