Measures of postprandial lipoproteins are not associated with coronary artery disease in patients with type 2 diabetes mellitus

Gissette Reyes-Soffer,Steve Holleran,Wahida Karmally,Colleen I Ngai,Niem-Tzu Chen,Margarita Torres,Rajasekhar Ramakrishnan,William S Blaner,Lars Berglund,Henry N Ginsberg,Catherine Tuck

doi:10.1194/jlr.m900092-jlr200

Gissette Reyes-Soffer, Steve Holleran + Show 9 more

Open Access

https://doi.org/10.1194/jlr.m900092-jlr200

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Abstract

Individuals with type 2 diabetes mellitus (DM) characteristically have elevated fasting and postprandial (PP) plasma triglycerides (TG). Previous case-control studies indicated that PPTG levels predict the presence of coronary artery disease (CAD) in people without DM; however, the data for patients with DM are conflicting. Therefore, we conducted a case-control study in DM individuals, 84 with (+) and 80 without (-) CAD. Our hypothesis was that DM individuals with or without CAD would have similar PPTG levels, but CAD+ individuals would have more small d<1.006 g/L lipoprotein particles. Several markers of PP lipid metabolism were measured over 10 h after a fat load. PP lipoprotein size and particle number were also determined. There was no significant difference in any measure of PP lipid metabolism between CAD+ and CAD-, except for apoB48, which was actually higher in CAD-. We followed 69 CAD- participants for a mean 8.7 years; 33 remained free of any cardiovascular event. There were no PP differences at baseline between these 33 who remained CAD- and either the 36 original CAD- who subsequently developed CAD or the original CAD+ group.PP measurements of TG-rich lipoproteins do not predict the presence of CAD in individuals with DM.

Highlights

Individuals with type 2 diabetes mellitus (DM) characteristically have elevated fasting and postprandial (PP) plasma triglycerides (TG)
Remnant lipoproteins (ASCVD), coronary artery disease (CAD) [1], and a dyslipidemia characterized by high levels of plasma triglycerides (TG) and low levels of HDL cholesterol (C) [2, 3]
There were no significant differences in dietary intake between the CADϪ and CAD+ percent of calories: 18.1% protein, 33.4% fat, 47.6% carbohydrate, 10.1% saturated fat) group

Summary

Introduction

Individuals with type 2 diabetes mellitus (DM) characteristically have elevated fasting and postprandial (PP) plasma triglycerides (TG). In those studies, nonfasting TG concentrations remained independent predictors of ASCVD events, even after adjusting for other risk factors including HDL-C The importance of these recent findings is highlighted by the fact that most individuals are usually within a few hours of eating food during much of the day. Studies from several laboratories, including our own, have demonstrated that the excursion of plasma TG after ingestion of a high-fat meal is predictive of the presence of CAD [10,11,12,13] or carotid atherosclerosis [14] in people without DM In two of those studies [13, 14], the predictive power of PPTG was independent of fasting TG concentrations.

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