Incremental area under response curve more accurately describes the triglyceride response to an oral fat load in both healthy and type 2 diabetic subjects

Abstract

Elevation of postprandial triacylglycerol (TG)-rich plasma lipoproteins is considered potentially atherogenic. Type 2 diabetic patients have exaggerated postprandial TG compared with healthy subjects. Postprandial TG responses to oral fat loads are usually studied as the area under the TG curve. No consensus exists regarding the method of choice when calculating the TG response area. We evaluated the correlation between fasting TG and postprandial TG responses calculated by the trapezoid rule as total area under the curve (AUC) and incremental area under the curve (iAUC). Furthermore, we compared the AUC and iAUC to a 3-point calculation method. Ten healthy subjects and 47 type 2 diabetic patients ingested test meals consisting of an energy-free soup plus 80 g fat and 50 g carbohydrate. TG responses were measured in total plasma, in a chylomicron (CM)-rich fraction and in a CM-poor fraction. In healthy subjects the AUC, but not iAUC, correlated positively to fasting TG. In type 2 diabetic patients a strong correlation was found between fasting TG and AUC, whereas weak associations were found to the iAUCs. The iAUC was strongly correlated to the postprandial TG rise in both groups. The 3-point areas differed significantly from the trapezoid measurements in both healthy and type 2 diabetic subjects. In conclusion, in both healthy and type 2 diabetic subjects total AUC is highly correlated to fasting TG, whereas iAUC more accurately describes the TG response to an oral fat load. The 3-point test seems less suitable for the determination of postprandial response in both healthy and type 2 diabetic subjects.