Fat Postprandial Plasma Triglyceride Metabolism Abnormalities As Independent Risk Factors Of Coronary Heart Disease,

Background and Purpose: Fasting plasma triglyceride level is associated with the risk of coronary heart disease(CHD).However,in multivariate analyses,including other lipid parameters.this association is often weakened,even not maintained , primarily because high density lipoprotein (HDL) cholesterol(HDL-C),by virtue of its inverse association with triglyceride eliminates triglyceride as a risk factor for CHD . Elimination of triglyceride-rich lipoproteins as a risk factor for CHD through statistical analysis constitutes a paradox because many studies reveal increased serum triglyceride plus a low HDL-C provide better discrimination between CHD and controls, and HDL-C level is dependent on the metabolism of triglyceride-rich lipoproteins . To further evaluate the role of triglyceride-rich lipoproteins in CHD,we employed postprandial lipemia as a more informative method of characterizing triglyceride metabolism . We also investigated the influence of apoB signal peptide polymorphism and apoE polymorphism on the postprandial response of triglyceride-rich lipoproteins .Methods and Results: In 46 patients with CHD as verified by angiography (CHD group) and 34 control subjects without CHD on historical grounds, we measured the concentration of cholesterol , HDL-C , LDL-cholesterol (LDL-C) , apolipoprotein A I ,and apolipoprotein B in fasting serum and triglyceride before (0 hour) and 2,4,6,8 hours after a standard fat test meal. Univariate analyses indicated both triglyceride peak response (TGPR) and magnitude of postpradial lipemia ( area under the triglyceride curve over 8 hours after the meal, TG-AUC ) along with every single postpradial triglyceride level (2,4,6,and 8 hours after the meal) were significantly higher in cases of CHD than in control subjects . After correction for fasting triglyceride level,the significant differences between CHD cases and control subjects were maintained for TGPR , TG-AUC and single postpradial triglyceride level of 6 , 8 hours after the meal.The same was true when fasting serum HDL-C concentration and body mass index ( BMI, weight/height~2 )used as a covariate separately . The fasting levels of serum cholesterol, triglyceride , LDL-C , and apoB were significantly higher , while HDL-C significantly lower in cases of CHD compared with control subjects on univariate analyses . To define the independent association between postprandial lipemia ( TGPR or TG-AUC ) and case-control status , multiple stepwise...