Abstract
BackgroundPostprandial lipemia is an important cardiovascular risk factor. The assessment of postprandial lipid metabolism is a newly trend that several consortiums and countries have adopted. The aim of the study is to determine a postprandial triglyceride concentration cut-off point that accurately discriminate individuals with fasting normal triglyceride concentrations from those with fasting hypertriglyceridemia.MethodsCross sectional population-based study. A total of 212 subjects underwent an eight hours’ oral fat tolerance test. Samples were taken fasting, three, four, five, six and eight hours after the meal. The area under the receiver operating characteristic curve (c-statistic) was computed using postprandial triglycerides concentrations as independent predictor, and fasting hypertriglyceridemia as dependent variable.ResultsThe best threshold of postprandial lipemia to discriminate fasting hypertriglyceridemia was 280 mg/dL at any hour area under the curve 0.816 (95% confidence interval 0.753–0.866), bootstrap-corrected c-statistic = 0.733 (95% confidence interval 0.68–0.86). The same value was compared with apolipoprotein B concentrations (>90th percentile) having a good performance: area under the curve 0.687 95% confidence interval 0.624–0.751). Likewise, subjects with high postprandial lipemia have higher Globo risk scores.ConclusionThe 280 mg/dL cut-off point value of postprandial triglycerides concentration any time after a test meal discriminate subjects with fasting hypertriglyceridemia. This threshold has a good performance in a heterogeneous population and has a good concordance with cardiovascular risk surrogates.
Highlights
Postprandial lipemia is an important cardiovascular risk factor
Apolipoprotein B (Apo-B) levels were determined by kinetic nephelometry (Beckman Immage, Brea, CA and insulin concentrations were analyzed utilizing micro particles enzyme immunoassay (MEIA) (Abbot AxSYM System, Green Oaks, IL, USA)
The most suitable threshold of postprandial lipemia to discriminate fasting hypertriglyceridemia was 272 mg/dL at six-hour after the fat load (AUC 0.845, 95% confidence interval confidence intervals (CI) 0.800–0.80) with a sensitivity (Sens) of 74.4%, and specificity (Spec) 94.6%, positive predictive value (PPV) 0.94 and negative predictive value (NPV) 0.66, Spearman correlation = 0.88 p = 0.001
Summary
Postprandial lipemia is an important cardiovascular risk factor. The assessment of postprandial lipid metabolism is a newly trend that several consortiums and countries have adopted. Postprandial lipemia has been established as an important cardiovascular risk factor [1,2,3]. Since there is biological variation in the postprandial TG response, it is imperative to establish a population specific cut-off point. The identification of such threshold would be clinically convenient, since it Sevilla-González et al Lipids in Health and Disease (2018) 17:156 would allow the diagnosis of fasting abnormal concentration utilizing a postprandial sample. We aim to show that a postprandial TG cut-off point can accurately discriminate individuals with normal fasting triglyceride levels from those with fasting hypertriglyceridemia
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