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Low fasting low high-density lipoprotein and postprandial lipemia

DOI: 10.1186/1476-511x-3-18

Keywords: low high-density lipoprotein cholesterol, coronary heart disease, postprandial lipemia, triglyceride clearance.

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Fifty two Greek men were divided into 2 main groups: a) the low HDL group (HDL < 40 mg/dl), and b) the control group. Both groups were further matched according to fasting TG (matched-low HDL, and matched-control groups). The fasting TG concentrations were higher in the low HDL group compared to controls (p = 0.002). The low HDL group had significantly higher TG at 4, 6 and 8 h postprandially compared to the controls (p = 0.006, p = 0.002, and p < 0.001, respectively). The matched-low HDL group revealed higher TG only at 8 h postprandially (p = 0.017) compared to the matched-control group. ROC analysis showed that fasting TG ≥ 121 mg/dl have 100% sensitivity and 81% specificity for an abnormal TG response (auc = 0.962, p < 0.001).The delayed TG clearance postprandially seems to result in low HDL cholesterol even in subjects with low fasting TG. The fasting TG > 121 mg/dl are predictable for abnormal response to fatty meal.The hypothesis that low levels of high density lipoprotein (HDL) cholesterol is associated with coronary heart disease (CHD), raised since the 1950s [1]. Fifty years later, it was well-established [2,3] as it has been excellently proved after a number of large prospective studies [4,5]. In the PROCAM Study [6] 45% of men and women who developed CHD had an HDL cholesterol lower than 35 mg/dl. In the Framingham Heart Study, total cholesterol levels did not provide a predictive value in identifying people at risk for CHD compared to cholesterol/HDL ratio [7]. Furthermore, a change in ratio is better predictor for successful CHD risk reduction than changes in total cholesterol levels. There is no longer any doubt that HDL cholesterol is a powerful independent inverse predictor of CHD. On the other hand, the long duration of the postprandial lipemia and repetition of meals during the daytime leads to important changes of lipoproteins postprandially. Studies have shown that disturbed postprandial lipemia is found in patients with CHD [8,9] and other cond


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