Postprandial Lipids Levels After A Pure Fatty Meal And Their Relationships With Carotid Atherosclerosis In Type 2 Diabetics

Objective: To observe the changes of postprandial lipids after a pure fatty tolerant test (FTT) and test the effect of postprandial lipids on carotid artery atherosclerosis.Materials and Methods: 37 type 2 diabetes mellitus were recruit by oral glucose tolerant test (OGTT) and 15 nondiabetic subjects, glycosylated hemoglobin (HbAlc) and insulin in fasting serum, glucose (GLU), triglycerides (TG)n total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) , apolipoprotein A I (apoA I) , apolipoprotein B (apoB) , lipoprotein(a) [LP(a)] , free fatty acid (FFA) concentration in fasting and postprandial 2, 4, 6 hours after the FTT were measured. Each object underwent a carotid artery high-resolution B-mode ultrasound examination and the carotid artery intima-media thickness(IMT) were measured. Results:1. After the fat meal, an increase of postprangdial TG and FFA were observed in both groups. The fasting and 2, 4, 6 hours after meal levels of TG and FFA were much higher in type 2 diabetics than the normal control. The peak TG concentration and FFA concentration were delated. TG area under the curve (TG-AUC) and TG peak response(TG-PR) were significantly high in diabetic group. (p<0.05). The TG-AUC and FFA-AUC were positively correlated with the TGconcentration and FFA concentration at 4, 6 hours after the fat meal. (r=0.733,r=0.637 ; p<0.01 and r=0.623,r=0.475; p<0.01).2. The HDL-C concentrations in type 2 diabetic group were lower before and after the FTT than the control group. In the diabetic groups the HDL-C levels were decreased at 2> 4> 6 hours after fat meal(p<0.05) .3. The IMT of diabetic and control troups were (0.98 + 0.37)mm and (0.77 + 0.21)mm and they had significantly different (p<0.05).4. In the stepwise regression about IMT and its relative factors, taken fasting glucose^ fasting lipids n age> sex> course of diseasen BMK WHR> WC, DBP, SBP, TG-AUC and FFA-AUC as variables, TG-AUC and BMI were positively correlated with IMT. When replace TG-AUC and FFA-AUC with TG-PR and FFA-PR, TG-PR and BMI were correlated with IMT. Conclusion:1. The pure FTT is easy and sensitivity, which can be accepted by patients, so it canbe regarded as a good method to evaluated the postprandial lipids.2.There was severe and delated lipids dysfunction, especially in the postprandialstatus, in type 2 diabetes mellitus. The concentration of TG and FFA at 4 hour afterthe FTT has the best correlation ship with the TG-AUC and FFA-AUC, so we candetect the concentration of TG and FFA at 4 hour to make the test easy.3. BMI n TG-PR and TG-AUC were independently and significantlycorrelated with IMT. Which suggest that postprandial hypertriglyceridemiaand triglycerio rich lipoprotein may independent predictors of vascularcomplications.