Postprandial lipaemia, whether measured using levels of triglyceride or retinyl palmitate, is more severe in patients with coronary heart disease; however, little improvement in the discrimination between individuals with and without coronary heart disease can be made using postprandial measurements rather than measuring levels of high-density-lipoprotein2 cholesterol or apolipoprotein B. Retinyl palmitate levels occasionally reveal differences not apparent from triglyceride measurements. Elevated fasting and postprandial triglyceride levels may produce clinical disease partly by enhancing coagulation and by interfering with fibrinolysis.
EvansAJSawyezCGWolfeBMConnellyPWMaguireCFHuffMW: Evidence that cholesteryl ester and triglyceride accumulation in 1774 macrophages induced by very low density lipoprotein subfractions occurs by different mechanisms. J Lipid Res1993, 34:703–717.
2.
HuffMWEvansAJSawyezCGWolfeBMNestelPJ: Cholesterol accumulation in 1774 macrophages induced by triglyceride-rich lipoproteins. Comparison of very low density lipoprotein from subjects with type III, IV and V hyperlipo-proteinaemias. Arterioscler Thromb1991, 11:221–233.
3.
ChoiSYFongLGKirvenMJCooperAD: Use of an anti-low density lipoprotein receptor antibody to quantify the role of the LDL receptor in the removal of chylomicron remnants in the mouse in vivo. J Clin Invest1991, 88:1173–1181. The authors found that an antibody to the LDL receptor reduced hepatic uptake of chylomicron remnants by one-half.
4.
JackieSHuberCMoestrupSGliemannJBeisiegelU: In-vivo removal of beta-VLDL, chylomicron remnants, and alpha-2-macroglobulin in the rat. J Lipid Res1993, 34:309–315. The authors found that the clearance of beta-VLDL and chylomicron remnants is mediated predominantly via the LDL receptor.
5.
ChenQFlorenCHNilssonA: Lipoprotein receptor mediated metabolism of [14C]arachidonic acid labeled chylomicron remnants by HepG2 cells. Lipids1992, 27:664–668.
6.
ErikssonMAngelinBHenrikssonPEricssonSVitolsSBerglundL: Metabolism of lipoprotein remnants in humans. Studies during intestinal infusion of fat and cholesterol in subjects with varying expression of the low density lipoprotein receptor. Arterioscler Thromb1991, 11:827–837.
7.
BowlerARedgraveTGMamoJC: Chylomicron-remnant clearance in homozygote and heterozygote Watanabe heritable hyperlipidaemic rabbits is defective. Lack of evidence for an independent chylomicron-remnant receptor. Biochem J1991, 276:381–386.
8.
SimpsonHSWilliamsonCMOlivecronaTPringleSMacleanJLorimerAR: Postprandial lipemia, fenofibrate and coronary artery disease. Atherosclerosis1990, 85:193–202. The authors found that patients with CHD had lower levels of HDL cholesterol and more severe postprandial lipaemia; whether the latter improved discrimination was not tested.
9.
GrootPHvan StiphoutWAKraussXHJansenHvan TolAvan RamshorstE: Postprandial lipopotein metabolism in normolipidemic men with and without coronary artery disease. Arterioscler Thromb1991, 11:653–662. This is a well-controlled study that showed delayed triglyceride clearance in normolipidaemic men with CHD, who had a low level of HDL cholesterol compared with controls. Whether this increased case discrimination, however, was not examined.
10.
PatschJRMiesenbockGHopferwieserTMuhlbergerVKnappEDunnJK: Relation of triglyceride metabolism and coronary artery disease. Studies in the postprandial state. Arterioscler Thromb1992, 12:1336–1345. The authors found that the postprandial triglyceride level was as accurate a predictor as the fasting level of HDL2 cholesterol and marginally improved case discrimination.
11.
KarpeFSteinerGOlivecronaTCarlsonLAHemstenA: Metabolism of triglyceride-rich lipoproteins during alimentary lipemia. J Clin Invest1993, 91:748–758. This is a very detailed study of postprandial lipaemia that showed no differences between patients with CHD and controls. The number of patients and controls was small, however.
12.
KarpeFBardJMSteinerGCarlsonLAFruchartJCHamstenA: HDLs and alimentary lipemia. Studies in men with previous myocardial infarction at a young age. Arterioscler Thromb1993, 13:11–22. The authors found that the progression of disease was related to the level of Sf20–60 apoB48 (small chylomicron remnants).
ConnerJ ALeNACoatesPMBennettMJCryerDR: Determinant of fasting plasma triglyceride levels: Metabolism of hepatic and intestinal lipoproteins. Eur J Clin Invest1992, 22:158–165.
15.
ChenYDSwamiSSkowronskiRCoulstonAReavenGM: Differences in postprandial lipemia between patients with normal glucose tolerance and non-insulin-dependent diabetes mellitus. J Clin Endocrinol Metab1993, 76:172–177. The authors found that patients with non-insulin-dependent diabetes have an enhanced postprandial response, assessed using retinyl palmitate levels in the Sf 20–400 fraction, despite having fasting and postprandial triglyceride levels similar to those of normal subjects.
16.
LewisGFO'MearaNMSoltysPABlackmanJDIveriusPHPughWL: Fasting hypertriglyceridemia in non-insulin-dependent diabetes mellitus is an important predictor of postprandial lipid and lipoprotein abnormalities. J Clin Endocrinol Metab1991, 72:934–944.
17.
SchneemanBOKotiteLToddKMHavelRJ: Relationships between the responses of triglyceride-rich lipoproteins in blood plasma containing apolipoproteins B48 and B100 to a fat-containing meal in normolipidemic humans. Proc Natl Acad Sci USA1993, 90:2069–2073. Eighty per cent of the increase in the number of particles and 90% of the increase in cholesterol after a fatty meal was found to be in the apoB100 fraction. VLDL composition did not change. The rise in apoB48 and apoB100 was highly correlated. This means studies using apoB48 or retinyl palmitate as markers may produce incorrect estimates of the total postprandial response if apoB48 and apoB100 are not always correlated.
18.
CohnJSWagnerDACohnSDMillarJSSchaeferEJ: Measurement of very low density and low density lipoprotein apolipoprotein (apo)B100 and high density lipoprotein apoA-I production in human subjects using deuterated leucine. Effect of fasting and feeding. J Clin Invest1990, 85:804–811. The authors found that the consumption of a fatty meal increased VLDL production by 50%.
19.
CohnJSJohnsonEJMillarJSCohnSDMilneRWMarcelYL: Contribution of apoB48 and apoB100 triglyceriderich lipoproteins (TRL) to postprandial increases in the plasma concentration of TRL triglycerides and retinyl esters. J Lipid Res1993, 34:2033–2040. This study showed that 80% of the postprandial increase in triglyceride level is in apoB100 particles, which also contain 30% of the retinyl palmitate.
20.
RyuJEHowardGCravenTEBondMGHagamanAPCrouseJRIII: Postprandial triglyceridemia and carotid atherosclerosis in middle-aged subjects. Stroke1992, 23:823–828. The authors found that the thickness of the carotid wall was related only to postprandial triglyceride levels and smoking.
21.
WeintraubBBursteinARassinTLironMRingelYCabiliS: Severe defect in clearing postprandial chylomicron remnants in dialysis patients. Kidney Int1992, 42:1247–1252.
22.
BoerwinkleEBrownSSharrettARHeissGPatschW: Apolipoprotein E polymorphism influences postprandial retinyl palmitate but not triglyceride concentrations. Am J Hum Genet1994, 54:341–360.
23.
CianfloneKBilodeauMDavignonJSnidermanAD: Modulation of chylomicron remnant metabolism by an hepatic hydroxymethylglutaryl coenzyme A reductase inhibitor. Metabolism1990, 39:274–280.
24.
SilveirAKarpeFBlombaeckMSteinerGWalldiusGHamstenA: Activation of coagulation factor VII during alimentary lipemia. Arterioscler Thromb1994, 14:60–69.
25.
SiegertG: Effect of postprandial lipoprotein fractions on the fibrinolytic system [in German]. Klinische Wochenschrift1990, 68 (suppl 22):122.
26.
CohenJCGrundySM: Normal postprandial lipemia in men with low plasma HDL concentrations. Arterioscler Thromb1992, 12:972–975. The authors found that men with low HDL and normal triglyceride levels had a postprandial response similar to that of men with normal HDL levels.
27.
O'MearaNMLewisGFCabanaVGIveriusPHGetzGSPolonskyKS: Role of basal triglyceride and high density lipoprotein in determination of postprandial lipid and lipoprotein responses. J Clin Endocrinol Metab1992, 75:465–471.
28.
MillerMKwiterovichPOJrBachorikPSGeorgopoulosA: Decreased postprandial response to a fat meal in normotrigly-ceridemic men with hypoalphalipoproteinaemia. Arterioscler Thromb1993, 13:385–392.
29.
CohenJCStray-GundersenJGrundySM: Dissociation between postprandial lipemia and high density lipoprotein cholesterol concentrations in endurance-trained men. Arterioscler Thromb1991, 11:838–843.
30.
HegeleRALittleJAVezinaCMaguireCFTuLWoleverTS: Hepatic lipase deficiency. Clinical, biochemical, and molecular genetic characteristics. Arterioscler Thromb1993, 13:720–728. This study revealed that hepatic lipase deficiency leads to impaired clearance of chylomicron remnants and accumulation of beta-VLDL.
31.
MiesenbockGHolzlBFogerBBrandstatterEPaulweberBSandherF: Heterozygous lipoprotein lipase deficiency due to a missense mutation as the cause of impaired triglyceride tolerance with multiple lipoprotein abnormalities. J Clin Invest1993, 91:448–455. Individuals with heterozygous lipoprotein lipase deficiency had a normal fasting triglyceride but an exaggerated postprandial response. Despite their normal fasting triglyceride levels, these patients had small LDL and HDL and low HDL2-cholesterol levels, suggesting that these lipid abnormalities occur because of elevated postprandial triglyceride levels.
32.
SimoIEYakichukJAOoiTC: Effect of gemfibrozil and lovastatin on postprandial lipoprotein clearance in the hypoalphalipoproteinemia and hypertriglyceridemia syndrome. Atherosclerosis1993, 100:55–64.
33.
HarrisWSMuzioF: Fish oil reduces postprandial triglyceride concentrations without accelerating lipid-emulsion removal rates. Am J Clin Nutr1993, 58:68–74.
34.
DemackerPNReijnenIGKatanMBStuytPMStalenhoefAF: Increased removal of remnants of triglyceride-rich lipoproteins on a diet rich in polyunsaturated fatty acids. Eur J Clin Invest1991, 21:197–203.
