Assessment and Clinical Relevance of Non-Fasting and Postprandial Triglycerides: An Expert Panel Statement

Title: Assessment and Clinical Relevance of Non-Fasting and Postprandial Triglycerides: An Expert Panel Statement

Volume: 9 Issue: 3

Author(s): Genovefa D. Kolovou, Dimitri P. Mikhailidis, Jan Kovar, Dennis Lairon, Borge G. Nordestgaard, Teik Chye Ooi, Pablo Perez-Martinez, Helen Bilianou, Katherine Anagnostopoulou and George Panotopoulos

Affiliation:

Keywords: Postprandial triglycerides, non-fasting triglycerides, chylomicron remnants, very low density lipoprotein remnants, fat tolerance test, cardiovascular disease, statins, fibrates, nicotinic acid, type IIb hyperlipidemia

Abstract: 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.

Cite this article as:

D. Kolovou Genovefa, P. Mikhailidis Dimitri, Kovar Jan, Lairon Dennis, G. Nordestgaard Borge, Chye Ooi Teik, Perez-Martinez Pablo, Bilianou Helen, Anagnostopoulou Katherine and Panotopoulos George, Assessment and Clinical Relevance of Non-Fasting and Postprandial Triglycerides: An Expert Panel Statement, Current Vascular Pharmacology 2011; 9 (3) . https://dx.doi.org/10.2174/157016111795495549