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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2001;21:275.)
© 2001 American Heart Association, Inc.

Atherosclerosis and Lipoproteins

Metabolic and Lifestyle Determinants of Postprandial Lipemia Differ From Those of Fasting Triglycerides

The Atherosclerosis Risk in Communities (ARIC) Study

A. R. Sharrett; G. Heiss; L. E. Chambless; E. Boerwinkle; S. A. Coady; A. R. Folsom; W. Patsch

From the Epidemiology and Biometry Program (A.R.S., S.A.C), National Heart, Lung, and Blood Institute, Bethesda, Md; the Departments of Epidemiology (G.H.) and Biostatistics (L.E.C.), University of North Carolina School of Public Health, Chapel Hill; the Genetics Center (E.B.), University of Texas Health Science Center, Houston; the Division of Epidemiology (A.R.F.), School of Public Health, University of Minnesota, Minneapolis; and the Department of Laboratory Medicine (W.P.), Landeskrankenanstalten, Salzburg, Austria.

Correspondence to A. Richey Sharrett, MD, DrPH, Division of Epidemiology and Clinical Applications, Room 8164, MSC 7934, National Heart, Lung, and Blood Institute, 6701 Rockledge Dr, Bethesda, MD 20892-7934. E-mail Sharretr{at}nih.gov

Abstract—Despite the reported association of lipoprotein responses to a fatty meal with atherosclerosis, little is known about the determinants of these responses. Plasma triglyceride, retinyl palmitate, and apolipoprotein B-48 responses to a standardized fatty meal containing a vitamin A marker were measured in 602 Atherosclerosis Risk in Communities (ARIC) study participants. To focus on postprandial responses specifically, which have been reported to be related to atherosclerosis independently of fasting triglycerides, analyses for determinants of postprandial responses were adjusted for fasting triglycerides. Major determinants of fasting triglycerides, namely, diabetes, obesity, other factors related to insulin resistance, and male sex, were not independently associated with postprandial responses. Fasting triglycerides were the strongest predictor of postprandial lipids, but independent of triglycerides, the predictors of postprandial responses were smoking, diet, creatinine, and alcohol. Smokers had substantially increased retinyl palmitate and apolipoprotein B-48 responses, indicators of chylomicrons and their remnants. Persons who consume more calories or 3 fatty acids had reduced chylomicron responses. Triglyceride responses were associated positively with serum creatinine levels and negatively with moderate alcohol consumption. Thus, determinants of fasting and postprandial lipids differ. The independent atherogenic influence of postprandial lipids may relate more to smoking and diet than to obesity and insulin resistance.

Key Words: lipoproteins • postprandial • chylomicrons

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