Assessment of the Validity and Reproducibility of a Novel Standardized Test Meal for the Study of Postprandial Triacylglycerol Concentrations

Nikolaos Tentolouris,Nikolaos Chaviaras,Nikolaos Katsilambros,Petros P Sfikakis,Panagiotis T Kanellos,Genovefa Kolovou,Evangelia Siami,Elpida Athanasopoulou

doi:10.1007/s11745-017-4275-9

Nikolaos Tentolouris, Nikolaos Chaviaras + Show 6 more

Open Access

https://doi.org/10.1007/s11745-017-4275-9

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Abstract

Lipotest® is a standardized fat-rich meal designed for use as a test meal during a fat tolerance test (FTT) for the study of postprandial triacylglycerol (TAG) concentrations. Herein we examined the precision and reproducibility of examination using Lipotest® on postprandial TAG levels. A total of 26 healthy consenting subjects were examined twice after 8–10 h fasting with an interval of approximately 1 week apart. Blood samples were collected at baseline and 1, 2, 3, and 4 h after consumption of the test meal for measurement of plasma total TAG levels. We examined agreement, precision, and accuracy between the two visits using the Altman plots and correlation coefficient. Reproducibility was tested using the coefficient of variation (CV) and intraclass correlation coefficient (ICC). Moreover, the area under the curve (AUC) as a summary measure of the overall postprandial TAG levels was calculated. The agreement, precision (r ≥ 0.74, p < 0.001), and accuracy (≥0.99) between the measurements in plasma TAG during Lipotest® testing in the two visits were high. In terms of reproducibility, the values of CV were 15.59–23.83% while those of ICC were ≥0.75. The values of the AUCs in the visits were not different (p = 0.87). A single measurement of plasma TAG levels at 4 h after Lipotest® consumption depicted peak postprandial TAG concentration. A FTT using Lipotest® as a standardized meal has good precision and reproducibility for the study of postprandial TAG levels in healthy individuals. A single determination of plasma TAG concentration at 4 h after Lipotest® consumption captures peak postprandial TAG response.

Highlights

Cardiovascular disease (CVD) is the leading cause of death worldwide [1]
It is apparent that standardization of a test meal and determination of the time after meal consumption for measurement of serum TAG concentrations is necessary for the study of postprandial triglyceridemia in a way similar to oral glucose tolerance test (OGTT) used for the diagnosis of diabetes and/ or impaired glucose regulation [15, 16]
We found that in all subjects, plasma TAG levels peaked until the 4th hour; afterwards, in four subjects they remained approximately stable until the 6th hour and they declined, while in six subjects plasma TAG concentrations declined after the 4th hour

Summary

Introduction

Cardiovascular disease (CVD) is the leading cause of death worldwide [1]. Fasting concentration of serum lipids and lipoproteins explain only in part the complex relationshipLipids (2017) 52:675–686 between dyslipidemia and CVD [2]. There are several methodological issues in all studies dealing with the effect of nonfasting triglyceridemia on CVD, because no standard test meal and no definite time or cut-off TAG value after meal consumption have been used to examine postprandial lipemia. It is apparent that standardization of a test meal and determination of the time after meal consumption for measurement of serum TAG concentrations is necessary for the study of postprandial triglyceridemia in a way similar to oral glucose tolerance test (OGTT) used for the diagnosis of diabetes and/ or impaired glucose regulation [15, 16]. According to the report of the expert panel statement regarding standardized postprandial TAG testing [17], a single fat tolerance test (FTT) should be performed after an 8 h fast and should consist of 75 g of fat, 25 g of carbohydrates and 10 g of protein; a single TAG measurement 4 h after a FTT meal provides a good evaluation of the postprandial TAG response

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