Background

Elevated postprandial triglycerides reflect a proatherogenic milieu, but underlying mechanisms are unclear.

Objective

We examined differences between fasting and nonfasting profiles of directly measured lipoprotein size and subfractions to assess if postprandial triglycerides reflected increases in very low density lipoprotein (VLDL), intermediate density lipoprotein (IDL) and remnants, or small dense lipid depleted LDL (sdLDL) particles.

Methods

We conducted a cross-sectional analysis of 15,397 participants (10,135 fasting; 5262 nonfasting [<8 hours since last meal]) from the VITamin D and OmegA-3 TriaL. Baseline cholesterol subfractions were measured by the vertical auto profile method and particle subfractions by ion mobility. We performed multivariable linear regression adjusting for cardiovascular and lipoprotein-modifying risk factors.

Results

Mean age (SD) was 68.0 years (±7.0), with 50.9% women. Adjusted mean triglyceride concentrations were higher nonfasting by 17.8 ± 1.3%, with higher nonfasting levels of directly measured VLDL cholesterol (by 3.5 ± 0.6%) and total VLDL particles (by 2.0 ± 0.7%), specifically large VLDL (by 12.3 ± 1.3%) and medium VLDL particles (by 5.3 ± 0.8%), all P < .001. By contrast, lower concentrations of low density lipoprotein (LDL) and IDL cholesterol and particles were noted for nonfasting participants. sdLDL cholesterol levels and particle concentrations showed no statistically significant difference by fasting status (−1.3 ± 2.1% and 0.07 ± 0.6%, respectively, P > .05).

Conclusions

Directly measured particle and cholesterol concentrations of VLDL, not sdLDL, were higher nonfasting and may partly contribute to the proatherogenicity of postprandial hypertriglyceridemia. These differences, although statistically significant, were small and may not fully explain the increased risk of postprandial hypertriglyceridemia.

中文翻译：

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比较15,397名显然健康的人的非空腹和空腹脂蛋白亚组分和大小：从VITamin D和OmegA-3 TriaL进行的分析。

背景

餐后甘油三酯升高反映出动脉粥样硬化的环境，但尚不清楚其潜在机制。

目的

我们检查了直接测量脂蛋白大小和亚组分的空腹和非空腹曲线之间的差异，以评估餐后甘油三酸酯是否反映出极低密度脂蛋白（VLDL），中密度脂蛋白（IDL）和残留物，或小的致密脂质耗尽LDL（sdLDL）颗粒的增加。

方法

我们对来自VITamin D和OmegA-3 TriaL的15,397名参与者（空腹10,135例；非空腹5262例[自上一餐以来<8小时以内）进行了横断面分析。基线胆固醇亚组分通过垂直自动轮廓法测量，颗粒亚组分通过离子迁移率测量。我们对心血管和脂蛋白修饰危险因素进行了多元线性回归调整。

结果

平均年龄（SD）为68.0岁（±7.0），其中50.9％为女性。调整后的甘油三酸酯平均非空腹浓度较高，为17.8±1.3％，而直接测量的VLDL胆固醇（由3.5±0.6％）和总VLDL颗粒（由2.0±0.7％），特别是较大的VLDL（由12.3±1.3％）较高的非空腹水平）和中层VLDL颗粒（5.3±0.8％），所有P  <.001。相比之下，非空腹参与者的低密度脂蛋白（LDL）和IDL胆固醇和颗粒的浓度较低。sdLDL胆固醇水平和颗粒浓度在禁食状态下无统计学差异（分别为-1.3±2.1％和0.07±0.6％，P  > 0.05）。

结论

直接测量的VLDL而不是sdLDL的颗粒和胆固醇浓度具有较高的非禁食率，可能部分有助于餐后高甘油三酯血症的促动脉粥样硬化。这些差异尽管具有统计学意义，但差异很小，可能无法完全解释餐后高甘油三酯血症的风险增加。