1
|
Keirns BH, Sciarrillo CM, Poindexter KL, Dixon MD, Medlin AR, Koemel NA, Hart SM, Geist CH, Jenkins NDM, Lucas EA, Emerson SR. Postprandial triglycerides across the aging spectrum: A secondary analysis utilizing an abbreviated fat tolerance test. Nutr Metab Cardiovasc Dis 2024; 34:121-125. [PMID: 37788958 DOI: 10.1016/j.numecd.2023.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/31/2023] [Accepted: 08/25/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND & AIMS Elevated postprandial triglycerides are an independent cardiovascular disease risk factor and observed in older adults. However, differences in postprandial triglycerides across the spectrum of adulthood remain unclear. METHODS AND RESULTS We performed a secondary analysis of six studies where adults (aged 18-84 years; N = 155) completed an abbreviated fat tolerance test (9 kcal/kg; 70% fat). Differences in postprandial triglycerides were compared in those ≥50 and <50 years and by decade of life, adjusting for sex and BMI. Compared to those <50 years, participants ≥50 years had higher fasting, 4 h, and Δ triglycerides from baseline (p's < 0.05). When examining triglyceride parameters by decade, no differences were observed for fasting triglycerides, but 50 s, 60 s, and 70s-80 s displayed greater 4 h and Δ triglycerides versus 20 s (p's ≤ 0.001). The frequency of adverse postprandial triglyceride responses (i.e., ≥220 mg/dL) was higher in participants ≥50 versus <50 years (p < 0.01), and in 60 s compared to all other decades (p = 0.01). CONCLUSION Older age was generally associated with higher postprandial triglycerides, with no divergence across the spectrum of older adulthood. In our sample, postprandial triglyceride differences in older and younger adults were driven by those >50 years relative to young adults in their 20 s. REGISTRATION N/A (secondary analysis).
Collapse
Affiliation(s)
- Bryant H Keirns
- Department of Nutrition and Health Science, Ball State University, Muncie, IN 47306, USA.
| | - Christina M Sciarrillo
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, 74075, USA
| | - Kara L Poindexter
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, 74075, USA
| | - Madison D Dixon
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, 74075, USA
| | - Austin R Medlin
- Department of Health & Wellness Design, Indiana University School of Public Health, 1025 E. Seventh St., Bloomington, IN 47405, USA
| | - Nicholas A Koemel
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, USA; Sydney Medical School, The University of Sydney, NSW, 2006, Australia
| | - Samantha M Hart
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, 74075, USA
| | - Caroline H Geist
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, 74075, USA
| | - Nathaniel D M Jenkins
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA, 52242, USA; Abboud Cardiovascular Research Center, University of Iowa, Iowa City, IA, 52242, USA
| | - Edralin A Lucas
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, 74075, USA
| | - Sam R Emerson
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, 74075, USA
| |
Collapse
|
2
|
Balaban Yucesan F, Demir EN, Ozer Yaman S, Orem A, Dokuz Murat B, Bilgin B. Short-Term Standard Diet Consumption Prior to the Oral Fat Tolerance Test Modulates the Postprandial Triglyceride Response. Metabolites 2023; 13:1019. [PMID: 37755299 PMCID: PMC10537398 DOI: 10.3390/metabo13091019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/06/2023] [Accepted: 09/14/2023] [Indexed: 09/28/2023] Open
Abstract
We hypothesized that the consumption of a 3-day standard diet (SD) prior to the oral fat tolerance test (OFTT), used to evaluate postprandial lipemia, may counteract the undesirable effects of individual dietary habits on the test results. The OFTT was applied to 22 healthy adults (11 females and 11 males), after their habitual diets (HDs) and following the consumption of a 3-day SD (45-60% energy from carbohydrate, 20-35% from fat, and 10-20% from protein). Plasma triglyceride (TG) concentrations were measured during fasting and at the fourth hour of the OFTT. A 3-day SD significantly reduced fasting and fourth-hour TG concentrations and delta TG values by 10%, 12.8%, and 22.7%, respectively. Decreases were observed in fasting and fourth-hour TG and delta TG values following the 3-day SD compared to the HD in subjects with fasting TG concentrations between 89 and 180 mg/dL (p = 0.062, p = 0.018, and 0.047, respectively). As a result, the consumption of a 3-day standardized diet prior to the OFTT may be useful to eliminate the false positive or negative effects of individual dietary habits on test results and to correctly identify individuals who should be administered the OFTT.
Collapse
Affiliation(s)
- Fulya Balaban Yucesan
- Department of Medical Biochemistry, Faculty of Medicine, Karadeniz Technical University, 61080 Trabzon, Turkey; (E.N.D.); (S.O.Y.); (A.O.); (B.B.)
| | - Eda Nur Demir
- Department of Medical Biochemistry, Faculty of Medicine, Karadeniz Technical University, 61080 Trabzon, Turkey; (E.N.D.); (S.O.Y.); (A.O.); (B.B.)
| | - Serap Ozer Yaman
- Department of Medical Biochemistry, Faculty of Medicine, Karadeniz Technical University, 61080 Trabzon, Turkey; (E.N.D.); (S.O.Y.); (A.O.); (B.B.)
| | - Asım Orem
- Department of Medical Biochemistry, Faculty of Medicine, Karadeniz Technical University, 61080 Trabzon, Turkey; (E.N.D.); (S.O.Y.); (A.O.); (B.B.)
| | - Busra Dokuz Murat
- Department of Nutrition and Dietetics, Institute of Health Sciences, Marmara University, 34854 Istanbul, Turkey;
| | - Busra Bilgin
- Department of Medical Biochemistry, Faculty of Medicine, Karadeniz Technical University, 61080 Trabzon, Turkey; (E.N.D.); (S.O.Y.); (A.O.); (B.B.)
| |
Collapse
|
3
|
Sciarrillo CM, Short KR, Keirns BH, Elliott DC, Clarke SL, Palle S, Emerson SR. Postprandial triglycerides and fibroblast growth factor 19 as potential screening tools for paediatric non-alcoholic fatty liver disease. Pediatr Obes 2023; 18:e13007. [PMID: 36734693 DOI: 10.1111/ijpo.13007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 12/16/2022] [Accepted: 01/04/2023] [Indexed: 02/04/2023]
Abstract
BACKGROUND Better screening tools for paediatric NAFLD are needed. We tested the hypothesis that the postprandial triglyceride (TG) and fibroblast growth factor 19 (FGF19) response to an abbreviated fat tolerance test (AFTT) could differentiate adolescents with NAFLD from peers with obesity and normal weight. METHODS Fifteen controls with normal weight (NW), 13 controls with obesity (OB) and 9 patients with NAFLD completed an AFTT. Following an overnight fast, participants consumed a high-fat meal. TG and FGF19 were measured at baseline and 4 h post-meal. Liver steatosis and fibrosis were measured via Fibroscan. RESULTS Fasting TG and FGF19 did not differ among groups; 4 h TG in the NAFLD and OB groups were greater (197 ± 69 mg/dL; 157 ± 72 mg/dL, respectively) than NW (105 ± 45 mg/dL; p < 0.05) and did not differ from one another. Within the entire cohort, 4 h TG were stratified by high and low steatosis. Adolescents with high steatosis had 98% greater 4 h TG than adolescents with low steatosis. 4 h FGF19, but not fasting FGF19, was higher in children with low steatosis compared with high steatosis (p < 0.05). Using area under the receiver operating curve (AUROC), the only biochemical outcome with diagnostic accuracy for NAFLD was 4 h TG (0.77 [95% CI: 0.60-0.94; p = 0.02]). CONCLUSIONS The postprandial TG response is increased in adolescents with obesity with hepatic steatosis, with or without NAFLD. Our preliminary analysis demonstrates 4 h TG differentiate patients with NAFLD from those without, supporting a role for the AFTT as a screening tool for paediatric NAFLD.
Collapse
Affiliation(s)
- Christina M Sciarrillo
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Kevin R Short
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Bryant H Keirns
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Destinee C Elliott
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Stephen L Clarke
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Sirish Palle
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Sam R Emerson
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, Oklahoma, USA
| |
Collapse
|
4
|
Saturated Fatty Acids Consumed in Smoothies Increase Glucose and Metabolic Load Index in Young Adults Compared to Polyunsaturated Omega-3-Fatty Acids. Nutrients 2023; 15:nu15030642. [PMID: 36771349 PMCID: PMC9919801 DOI: 10.3390/nu15030642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/19/2023] [Accepted: 01/25/2023] [Indexed: 01/28/2023] Open
Abstract
Introduction: Chronic diets high in saturated fat (SF) and omega-6-fatty acids (O6FAs) elevate fasting triglycerides (TRGs) and glucose (GLU). Postprandial TRGs, GLU, and Metabolic Load Index (MLI) are better predictors of disease risk compared to fasting levels alone. Conversely, diets high in omega-3 fatty acids (O3FAs) may be cardioprotective. Unfortunately, many existing postprandial studies are not standardized to body weight and given in an amount individuals would typically consume in their daily lives; the MLI is not calculated, and varying types of fat content are not examined. Therefore, we sought to determine whether SF, O3FAs, or O6FAs altered postprandial TRGs, GLU, and MLI from a standardized mixed meal. Methods: Fifteen individuals (6 M and 9 F) visited the laboratory three times, separated by at least 48 h, to consume HFM smoothies with varying FA composition (SF, high O6FAs, and high O3FAs). The smoothies were standardized to 12 kcal/kg body weight, 63% total fat, and 0.72 g/kg sugar. TRGs and GLU were collected at baseline and at 2 h and 4 h postprandially; the MLI was calculated by summing the TRG and GLU responses at each time point. Results: There was a significant increase in TRGs across time points (p < 0.001). For TRGs, there was a trend toward a significant interaction between smoothie type and time (p = 0.06) due to the increase in TRGs in the SF compared to the O3FA smoothie. There was an increase in postprandial GLU that varied across smoothie types (p = 0.036). Taken together, the MLI was elevated in the SF smoothie compared to the O3FAs at 2 h (p = 0.041). Conclusion: A SF smoothie in the morning elevated the metabolic load compared to an O3FA smoothie. Mechanisms of action in the competing clearance of TRGs and GLU warrant further investigation.
Collapse
|
5
|
Postprandial triglycerides, endothelial function, and inflammatory cytokines as potential candidates for early risk detection in normal-weight obesity. Obes Res Clin Pract 2022; 16:386-392. [PMID: 36127280 DOI: 10.1016/j.orcp.2022.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 08/09/2022] [Accepted: 08/29/2022] [Indexed: 11/24/2022]
Abstract
PROBLEM Normal-weight obesity (NWO) is associated with increased cardiovascular disease (CVD) risk. However, NWO's clinical presentation is often unremarkable based on common risk factors. We examined whether CVD risk factors not routinely measured clinically including postprandial triglycerides, flow-mediated dilation (FMD), and inflammatory cytokines would be abnormal in NWO, consistent with their future risk. METHODS Individuals were recruited into 3 groups (n = 10/ group): controls (Con), NWO, and metabolic syndrome (MetS). Con was defined as a normal body mass index (BMI), < 25% (M) or < 35% (F) body fat, and < 1 International Diabetes Federation (IDF) criteria. NWO were above this body fat cutoff while maintaining a normal BMI and MetS was defined per the IDF. Participants underwent an abbreviated fat tolerance test (i.e., difference in fasting and 4 h triglycerides following a high-fat meal [9 kcal/kg; 73% fat)] and fasting and postprandial lipid and glucose metrics, as well as FMD were measured. A T cell cytokine bioplex was also performed using fasting serum. RESULTS NWO and MetS had similar body fat% and both were higher than Con (p < 0.0001). Despite having similar fasting triglycerides to Con, NWO had 4-hour triglycerides 66% greater than Con, but 46% lower than MetS (p < 0.01). FMD decreased in all groups after the high-fat meal (p < 0.0001). MetS displayed lower fasting FMD than Con, and NWO was similar to both groups (p < 0.05). No group differences were observed with postprandial FMD and the majority of fasting cytokines assessed. However, MetS exhibited higher fasting TNF-α than Con (p < 0.05), and NWO was similar to both groups. CONCLUSIONS Overall, NWO was associated with higher postprandial triglycerides than Con, but displayed little evidence of impaired vascular health or inflammation.
Collapse
|
6
|
Comparison of a Standardized High-Fat Meal versus a High-Fat Meal Scaled to Body Mass for Measuring Postprandial Triglycerides: A Randomized Crossover Study. Metabolites 2022; 12:metabo12010081. [PMID: 35050203 PMCID: PMC8779546 DOI: 10.3390/metabo12010081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/11/2022] [Accepted: 01/12/2022] [Indexed: 02/01/2023] Open
Abstract
Post-meal triglycerides are an independent cardiovascular disease (CVD) risk factor, but the ideal high-fat meal formulation has yet to be standardized and is one challenge prohibiting widespread clinical adoption of postprandial triglyceride assessment. Two general approaches often used are giving individuals a high-fat meal scaled to body weight or a standardized high-fat meal containing a set fat bolus. A recent expert panel statement has endorsed the latter, specifying 75 g of fat as an appropriate fat dosage. Despite this recommendation, no study to date has tested whether there is a difference in postprandial triglycerides or if risk classification is affected based on these different approaches. We recruited 16 generally healthy individuals with roughly equal distribution among body mass index (BMI)class (n = 5–6/per BMI category) and sex (n = 2–3 M/F) within each BMI class. Each participant underwent two abbreviated fat tolerance tests separated by ~1 week: one with a scaled to body weight high-fat meal (9 kcal/kg; 70% fat) and a standardized meal containing 75 g of fat (70% fat). Fasting, 4 h, and absolute change in triglycerides across the entire sample and within each BMI category were similar regardless of high-fat meal. Only one participant with obesity had discordant postprandial responses between the fat tolerance tests (i.e., different CVD risk classification). These findings suggest that, within a certain range of fat intake, generally healthy individuals will have a similar postprandial triglyceride response. Considering the greater convenience of utilizing standardized high-fat meals, our data suggest that a standardized high-fat meal may be acceptable for large-scale studies and clinical implementation.
Collapse
|
7
|
Keirns BH, Sciarrillo CM, Koemel NA, Emerson SR. Fasting, non-fasting and postprandial triglycerides for screening cardiometabolic risk. J Nutr Sci 2021; 10:e75. [PMID: 34589207 PMCID: PMC8453457 DOI: 10.1017/jns.2021.73] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 08/16/2021] [Accepted: 08/19/2021] [Indexed: 12/23/2022] Open
Abstract
Fasting triacylglycerols have long been associated with cardiovascular disease (CVD) and other cardiometabolic conditions. Evidence suggests that non-fasting triglycerides (i.e. measured within 8 h of eating) better predict CVD than fasting triglycerides, which has led several organisations to recommend non-fasting lipid panels as the new clinical standard. However, unstandardised assessment protocols associated with non-fasting triglyceride measurement may lead to misclassification, with at-risk individuals being overlooked. A third type of triglyceride assessment, postprandial testing, is more controlled, yet historically has been difficult to implement due to the time and effort required to execute it. Here, we review differences in assessment, the underlying physiology and the pathophysiological relevance of elevated fasting, non-fasting and postprandial triglycerides. We also present data suggesting that there may be a distinct advantage of postprandial triglycerides, even over non-fasting triglycerides, for early detection of CVD risk and offer suggestions to make postprandial protocols more clinically feasible.
Collapse
Affiliation(s)
- Bryant H. Keirns
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK74075, USA
| | | | - Nicholas A. Koemel
- Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, The University of Sydney, Sydney, NSW2006, Australia
- Sydney Medical School, The University of Sydney, Sydney, NSW2006, Australia
| | - Sam R. Emerson
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK74075, USA
| |
Collapse
|
8
|
Sciarrillo CM, Koemel NA, Keirns BH, Banks NF, Rogers EM, Rosenkranz SK, Kurti SP, Jenkins NDM, Emerson SR. Who would benefit most from postprandial lipid screening? Clin Nutr 2021; 40:4762-4771. [PMID: 34242916 PMCID: PMC10198766 DOI: 10.1016/j.clnu.2021.04.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 03/22/2021] [Accepted: 04/10/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND & AIMS Individuals with fasting triglycerides (TG) <150 mg/dL can experience a deleterious postprandial TG response ≥220 mg/dL to a high-fat meal (HFM). The purpose of this study was to identify individuals based on fasting TG that would benefit most from additional postprandial screening. METHODS We conducted a secondary analysis of 7 studies from our laboratories featuring 156 disease-free participants (64 M, 92 F; age 18-70 years; BMI 18.5-30 kg/m2). Participants observed a 10-12 h overnight fast, after which they consumed an HFM (10-13 kcal/kg body mass; 61-64% kcal from fat). Two methods were used to identify lower and upper fasting TG cut points. Method 1 identified the lower limit as the TG concentration at which ≥90% of individuals presented peak postprandial TG (PPTG) <220 mg/dL and the upper limit as the concentration which ≥90% of individuals presented PPTG ≥220 mg/dL. Method 2 utilized receiver operating characteristic (ROC) curves and identified the lower limit as the fasting TG concentration where sensitivity was ≈95% and the upper limit as the concentration at which specificity was ≈95%. RESULTS In Method 1, 90% of individuals with fasting TG >130 mg/dL (>1.50 mmol/L) exhibited PPTG ≥220 mg/dL (≥2.50 mmol/L), while 100% of individuals with fasting TG <66 mg/dL (0.75 mmol/L) had PPTG that did not exceed 220 mg/dL (2.50 mmol/L). In Method 2, when sensitivity was ≈95%, the corresponding fasting TG concentration was 70 mg/dL (0.79 mmol/L). When specificity was ≈95%, the corresponding fasting TG concentration was 114 mg/dL (1.29 mmol/L). Based on methods 1 and 2, there was a moderate positive association (r = 0.37, p < 0.004) between fasting and PPTG for individuals with fasting TG between 70 and 130 mg/dL (0.79-1.50 mmol/L), in which 24% exhibited PPTG ≥220 mg/dL (≥2.50 mmol/L) while 76% did not. CONCLUSIONS Postprandial TG testing is likely most useful for individuals with fasting TG concentrations between 70 and 130 mg/dL (0.79-1.50 mmol/L). Outside of this range, postprandial TG responses are largely predictable. Establishing a specific patient group for which postprandial TG testing is most useful may lead to earlier risk detection in these individuals.
Collapse
Affiliation(s)
| | - Nicholas A Koemel
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA; Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, University of Sydney, Sydney, Australia; Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Bryant H Keirns
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Nile F Banks
- Department of Health and Human Performance, Oklahoma State University, Stillwater, OK, USA; Department of Health and Human Physiology, University of Iowa, Iowa City, IA, USA
| | - Emily M Rogers
- Department of Health and Human Performance, Oklahoma State University, Stillwater, OK, USA; Department of Health and Human Physiology, University of Iowa, Iowa City, IA, USA
| | - Sara K Rosenkranz
- Department of Food, Nutrition, Dietetics and Health, Kansas State University, Manhattan, KS, USA
| | - Stephanie P Kurti
- Department of Food, Nutrition, Dietetics and Health, Kansas State University, Manhattan, KS, USA; Department of Kinesiology, James Madison University, Harrisonburg, VA, USA
| | - Nathaniel D M Jenkins
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA; Department of Health and Human Performance, Oklahoma State University, Stillwater, OK, USA; Department of Health and Human Physiology, University of Iowa, Iowa City, IA, USA
| | - Sam R Emerson
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA; Department of Food, Nutrition, Dietetics and Health, Kansas State University, Manhattan, KS, USA
| |
Collapse
|
9
|
Zhao Y, Liu L, Yang S, Liu G, Pan L, Gu C, Wang Y, Li D, Zhao R, Wu M. Mechanisms of Atherosclerosis Induced by Postprandial Lipemia. Front Cardiovasc Med 2021; 8:636947. [PMID: 33996937 PMCID: PMC8116525 DOI: 10.3389/fcvm.2021.636947] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 03/05/2021] [Indexed: 12/14/2022] Open
Abstract
Postprandial lipemia plays an important role in the formation, occurrence, and development of atherosclerosis, and it is closely related to coronary heart disease and other diseases involving endothelial dysfunction, oxidative stress, inflammation, and other mechanisms. Therefore, it has become a focus area for further research. The studies on postprandial lipemia mainly include TG, TRL, VLDL, CM, and remnant cholesterol. Diurnal triglyceride patterns and postprandial hyperlipidemia are very relevant and are now insufficiently covered. The possible mechanisms between postprandial lipemia and cardiovascular disease have been reviewed in this article by referring to relevant literature in recent years. The research progress on the effects of postprandial lipemia on endothelial function, oxidative stress, and inflammation is highlighted. The intervention of postprandial lipemia is discussed. Non-medicinal intervention such as diet and exercise improves postprandial lipemia. As medicinal intervention, statin, fibrate, ezetimibe, omega-3 fatty acids, and niacin have been found to improve postprandial lipid levels. Novel medications such as pemafibrate, PCSK9, and apoCIII inhibitors have been the focus of research in recent years. Gut microbiota is closely related to lipid metabolism, and some studies have indicated that intestinal microorganisms may affect lipid metabolism as environmental factors. Whether intervention of gut microbiota can reduce postprandial lipemia, and therefore against AS, may be worthy of further study.
Collapse
Affiliation(s)
- Yixi Zhao
- Comprehensive Department, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Longtao Liu
- Cardiovascular Department, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Shengjie Yang
- Comprehensive Department, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Guijian Liu
- Clinical Laboratory, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Limin Pan
- Comprehensive Department, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Chun Gu
- Clinical Laboratory, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yang Wang
- Comprehensive Department, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Dan Li
- Comprehensive Department, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ran Zhao
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Min Wu
- Comprehensive Department, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| |
Collapse
|
10
|
Dixon MD, Koemel NA, Sciarrillo CM, Lucas EA, Jenkins NDM, Emerson SR. The reliability of an abbreviated fat tolerance test: A comparison to the oral glucose tolerance test. Clin Nutr ESPEN 2021; 43:428-435. [PMID: 34024551 DOI: 10.1016/j.clnesp.2021.03.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 03/03/2021] [Accepted: 03/09/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND & AIMS Postprandial lipemia (PPL) is predictive of cardiovascular disease risk, but the current method for assessing PPL is a burdensome process. Recently, the validity of an abbreviated fat tolerance test (AFTT) has been demonstrated. As a continuation of this research, the purpose of this study was to determine the reliability of the AFTT and compare it to the reliability of the oral glucose tolerance test (OGTT). METHODS In this randomized crossover trial, 20 healthy adults (10 male and 10 female) completed 2 AFTTs and 2 OGTTs, each separated by a 1-week washout. For the AFTT, triglycerides (TG) were measured at baseline and 4 h post-consumption of a high-fat meal, during which time participants were able to leave the lab. For the OGTT, we measured blood glucose at baseline and 2 h post-consumption of a 75-g pure glucose solution, and participants remained in the lab. To determine reliability, we calculated within-subject coefficient of variation (WCV) and intraclass correlation coefficient (ICC). RESULTS The mean 4-h TG WCV for the AFTT was 12.6%, while the mean 2-h glucose WCV for the OGTT was 10.5%. ICC values for 4-h TG and TG change were 0.79 and 0.71, respectively, while ICC values for 2-h glucose and glucose change were 0.66 and 0.56, respectively. CONCLUSIONS Based on WCV and ICC, the TG response to an AFTT was similarly reliable to the glucose response to an OGTT in our sample of healthy adults, supporting the AFTT's potential as a standard clinical test for determining PPL. However, reliability of the AFTT needs to be further tested in individuals at greater risk for cardiometabolic disease.
Collapse
Affiliation(s)
- Madison D Dixon
- Department of Nutritional Sciences, Oklahoma State University, 301 Human Sciences, Oklahoma State University, Stillwater, OK 74078, Stillwater, OK, USA.
| | - Nicholas A Koemel
- Department of Nutritional Sciences, Oklahoma State University, 301 Human Sciences, Oklahoma State University, Stillwater, OK 74078, Stillwater, OK, USA.
| | - Christina M Sciarrillo
- Department of Nutritional Sciences, Oklahoma State University, 301 Human Sciences, Oklahoma State University, Stillwater, OK 74078, Stillwater, OK, USA.
| | - Edralin A Lucas
- Department of Nutritional Sciences, Oklahoma State University, 301 Human Sciences, Oklahoma State University, Stillwater, OK 74078, Stillwater, OK, USA.
| | - Nathaniel D M Jenkins
- Department of Health and Human Physiology, University of Iowa, E102 Field House, University of Iowa, Iowa City, Ioa 52242, Iowa City, IA, USA.
| | - Sam R Emerson
- Department of Nutritional Sciences, Oklahoma State University, 301 Human Sciences, Oklahoma State University, Stillwater, OK 74078, Stillwater, OK, USA.
| |
Collapse
|
11
|
Sciarrillo CM, Keirns BH, Elliott DC, Emerson SR. The effect of black coffee on fasting metabolic markers and an abbreviated fat tolerance test. Clin Nutr ESPEN 2021; 41:439-442. [PMID: 33487304 DOI: 10.1016/j.clnesp.2020.11.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/15/2020] [Accepted: 11/02/2020] [Indexed: 01/20/2023]
Abstract
BACKGROUND & AIMS Coffee is typically prohibited prior to metabolic assessment in clinical and research settings. However, whether coffee meaningfully alters fasted metabolic testing or the results of a fat tolerance test is unclear. We investigated whether allowing black coffee intake within a fast prior to blood work affected fasting triglycerides (TG) and glucose, as well as the postprandial lipemic and glycemic response following an abbreviated fat tolerance test (AFTT). METHODS Participants completed two randomized AFTTs separated by at least 1 week. For each AFTT, participants arrived into the laboratory following a 10 h overnight fast and consumed either 8 oz of water or black coffee. Thirty minutes later, a baseline blood draw was collected. Immediately following, participants consumed a standardized high-fat shake (70% fat; 9 kcal/kg body mass), vacated the laboratory, and returned 4 h later for a follow-up blood draw. RESULTS Ten healthy individuals (5M, 5F; age: 22.9 ± 3.8 years; BMI: 24.3 ± 2.6 kg/m2) completed the study. There was no difference between trials with regard to baseline TG (MD = 1.7 mg/dL; p = 0.74), 4 h TG (MD = 2.7 mg/dL; p = 0.75), Δ TG (MD = 4.4 mg/dL; p = 0.52), or % change TG (MD = 7.7%; p = 0.99). Similarly, following coffee consumption, baseline glucose was unchanged relative to water (MD = 0.4 mg/dL; p = 0.84) and there were no differences in postprandial glucose measures, including 4 h (MD = 0.9 mg/dL; p = 0.58), Δ (MD = 1.3 mg/dL; p = 0.31), and % change in glucose (MD = 1.6%; p = 0.29). CONCLUSION In our small study sample, coffee intake prior to an AFTT did not affect baseline or postprandial TG and glucose. Therefore, coffee intake prior to an AFTT may not affect its validity.
Collapse
Affiliation(s)
- Christina M Sciarrillo
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, 74078, USA.
| | - Bryant H Keirns
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, 74078, USA
| | - Destinee C Elliott
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, 74078, USA
| | - Sam R Emerson
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, 74078, USA
| |
Collapse
|
12
|
Parvaresh Rizi E, Baig S, Loh TP, Toh SA, Khoo CM, Tai ES. Two-Hour Postprandial Lipoprotein Particle Concentration Differs Between Lean and Obese Individuals. Front Physiol 2019; 10:856. [PMID: 31379592 PMCID: PMC6649689 DOI: 10.3389/fphys.2019.00856] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 06/20/2019] [Indexed: 12/20/2022] Open
Abstract
The concentrations of lipoprotein particles [high-density lipoproteins (HDLs), low-density lipoproteins (LDLs), very-low-density lipoproteins (VLDLs), and chylomicrons] are associated with the risk of cardiovascular diseases. Most studies have examined these associations in the fasting state. Previous studies have shown lipoprotein particle concentration change following meal, and these changes are different in individuals with obesity. In this study, we aimed to assess whether various meal compositions lead to adverse short-term (2-h) postprandial lipoproteinemia in obese insulin resistant (obese-IR) subjects as compared to lean insulin sensitive (lean-IS) subjects. In a randomized crossover trial, nine lean-IS and nine obese-IR Chinese men aged 22–35 years were challenged with isoenergetic and isovolumic meals rich in protein (HP), fat (HF), or carbohydrate (HC). Plasma samples were collected after a 10-h fast, as well as 1-h and 2-h post-meal and analyzed using nuclear magnetic resonance. Plasma concentration of large VLDLs and chylomicron particles was higher and increased more after all meals in obese-IR compared to lean-IS subjects. The HP meal decreased small LDL particle concentration in obese-IR subjects, and increased small HDL particle concentration in all subjects. The HF meal led to a decrease in small HDL concentration in all subjects. In conclusion, obese-IR subjects revealed a detrimental response to meal challenges even as early as 2-h after meal intake.
Collapse
Affiliation(s)
- Ehsan Parvaresh Rizi
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Department of Medicine, National University Health System, Singapore, Singapore
| | - Sonia Baig
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Tze Ping Loh
- Department of Laboratory Medicine, National University Health System, Singapore, Singapore
| | - Sue-Anne Toh
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Department of Medicine, National University Health System, Singapore, Singapore.,Duke-National University of Singapore Medical School, Singapore, Singapore.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Chin Meng Khoo
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Department of Medicine, National University Health System, Singapore, Singapore
| | - E Shyong Tai
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Department of Medicine, National University Health System, Singapore, Singapore.,Duke-National University of Singapore Medical School, Singapore, Singapore
| |
Collapse
|