Postprandial metabolism: from research to clinical practice

Abstract

Over the last decade, the importance of postprandial metabolism has increased, given that it is the physiological state of humans in modern society. Moreover, postprandial lipemia is considered as a key player in the development of the most important cardiometabolic diseases. In this regard, postprandial lipemia has become more important, since it has been demonstrated that nonfasting triglycerides (TGs) are independent predictors of the risk of cardio vascular disease (CVD) [1,2]. Interestingly, the postprandial phase has been associated with increased inflammation and oxidation, which influences vascular function through a permanent endothelial aggression by atherogenic lipoprotein. TGs are predominantly carried in fasting conditions in VLDLs and their remnants, and postprandially in chylomicrons and their remnants. This growing interest has led both clinicians and scientists to consider several aspects related to the postprandial state and its role as a risk factor of CVD in order to homogenize the study and the impact of the postprandial TG-rich lipoproteins (TRLs) [3]. Although, at this point, there is not a complete consensus, enough evidence sustains the further development of routine nonfasting/postprandial TG measurements for clinical and research purposes. Recommendations from the European Atherosclerosis Society state that therapeutic targeting of elevated plasma TGs (≥1.7 mmol/l or 150 mg/dl), a marker of TRLs and their remnants, may provide further benefit [4]. However, more clinical and methodology-oriented studies are needed to explore the determinants and pathophysiological aspects of exaggerated/delayed postprandial lipemia in greater detail.