© 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
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