Pablo Perez-Martinez1, Juan F Alcala-Diaz2, Edmon K Kabagambe3, Antonio Garcia-Rios2, Michael Y Tsai4, Javier Delgado-Lista2, Genovefa Kolovou5, Robert J Straka6, Francisco Gomez-Delgado2, Paul N Hopkins7, Carmen Marin2, Ingrid Borecki8, Elena M Yubero-Serrano2, James E Hixson9, Antonio Camargo2, Michael A Province10, Javier Lopez-Moreno2, Fernando Rodriguez-Cantalejo11, Francisco J Tinahones12, Dimitri P Mikhailidis13, Francisco Perez-Jimenez2, Donna K Arnett14, Jose M Ordovas15, Jose Lopez-Miranda2. 1. Lipid and Atherosclerosis Unit, Department of Internal Medicine, IMIBIC/Reina Sofia University Hospital/University of Cordoba, Cordoba, Spain; CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain. Electronic address: pablopermar@yahoo.es. 2. Lipid and Atherosclerosis Unit, Department of Internal Medicine, IMIBIC/Reina Sofia University Hospital/University of Cordoba, Cordoba, Spain; CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain. 3. Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA. 4. Department of Laboratory Medicine & Pathology, University of Minnesota, Minneapolis, MN, USA. 5. 1st Cardiology Department, Onassis Cardiac Surgery Center, Athens, Greece. 6. Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, MN, USA. 7. Department of Internal Medicine, University of Utah Health Sciences Center, Salt Lake City, UT, USA. 8. Division of Statistical Genomics in the Center for Genome Sciences of the Washington University, St. Louis, USA. 9. Human Genetics Center, University of Texas Health Science Center at Houston, Houston, TX, USA. 10. Department of Genetics Division of Statistical Genomics, Washington University School of Medicine, St. Louis, MO, USA. 11. Biochemical Laboratory, Hospital Universitario Reina Sofia, Cordoba, Spain. 12. CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Servicio de Endocrinologia y Nutricion, Hospital Clinico Virgen de la Victoria, Malaga, Spain. 13. Department of Clinical Biochemistry, Royal Free Hospital Campus, University College London Medical School, University College London, London, UK. 14. Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA. 15. Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University School of Medicine, Boston, MA, USA; Department of Epidemiology, National Center of Cardiovascular Investigations, Madrid, Spain; Madrid Institute of Advanced Studies-Food, Madrid, Spain.
Abstract
BACKGROUND: Previous studies have suggested that for clinical purposes, subjects with fasting triglycerides (TGs) between 89-180 mg/dl (1-2 mmol/l) would benefit from postprandial TGs testing. OBJECTIVE: To determine the postprandial TG response in 2 independent studies and validate who should benefit diagnostically from an oral-fat tolerance test (OFTT) in clinical practice. METHODS: A population of 1002 patients with coronary heart disease (CHD) from the CORDIOPREV clinical trial and 1115 white US subjects from the GOLDN study underwent OFTTs. Subjects were classified into 3 groups according to fasting cut points of TGs to predict the usefulness of OFTT: (1) TG < 89 mg/dl (<1 mmol/l); (2) TG, 89-180 mg/dl (1-2 mmol/l); and (3) TG > 180 mg/dl (>2 mmol/l). Postprandial TG concentration at any point > 220 mg/dl (>2.5 mmol/l) has been pre-established as an undesirable postprandial response. RESULTS: Of the total, 49% patients with CHD and 42% from the general population showed an undesirable response after the OFTT. The prevalence of undesirable postprandial TG in the CORDIOPREV clinical trial was 12.8, 50.3, and 89.7%, in group 1, 2, and 3, respectively (P < .001) and 11.2, 58.1, and 97.5% in group 1, 2, and 3, respectively (P < .001) in the GOLDN study. CONCLUSIONS: These two studies validate the predictive values reported in a previous consensus. Moreover, the findings of the CORDIOPREV and GOLDN studies show that an OFTT is useful to identify postprandial hyperlipidemia in subjects with fasting TG between 1-2 mmol/l (89-180 mg/dL), because approximately half of them have hidden postprandial hyperlipidemia, which may influence treatment. An OFTT does not provide additional information regarding postprandial hyperlipidemia in subjects with low TG (<1 mmol/l, <89 mg/dL) or increased TG (>2 mmol/l, >180 mg/dl).
RCT Entities:
BACKGROUND: Previous studies have suggested that for clinical purposes, subjects with fasting triglycerides (TGs) between 89-180 mg/dl (1-2 mmol/l) would benefit from postprandial TGs testing. OBJECTIVE: To determine the postprandial TG response in 2 independent studies and validate who should benefit diagnostically from an oral-fat tolerance test (OFTT) in clinical practice. METHODS: A population of 1002 patients with coronary heart disease (CHD) from the CORDIOPREV clinical trial and 1115 white US subjects from the GOLDN study underwent OFTTs. Subjects were classified into 3 groups according to fasting cut points of TGs to predict the usefulness of OFTT: (1) TG < 89 mg/dl (<1 mmol/l); (2) TG, 89-180 mg/dl (1-2 mmol/l); and (3) TG > 180 mg/dl (>2 mmol/l). Postprandial TG concentration at any point > 220 mg/dl (>2.5 mmol/l) has been pre-established as an undesirable postprandial response. RESULTS: Of the total, 49% patients with CHD and 42% from the general population showed an undesirable response after the OFTT. The prevalence of undesirable postprandial TG in the CORDIOPREV clinical trial was 12.8, 50.3, and 89.7%, in group 1, 2, and 3, respectively (P < .001) and 11.2, 58.1, and 97.5% in group 1, 2, and 3, respectively (P < .001) in the GOLDN study. CONCLUSIONS: These two studies validate the predictive values reported in a previous consensus. Moreover, the findings of the CORDIOPREV and GOLDN studies show that an OFTT is useful to identify postprandial hyperlipidemia in subjects with fasting TG between 1-2 mmol/l (89-180 mg/dL), because approximately half of them have hidden postprandial hyperlipidemia, which may influence treatment. An OFTT does not provide additional information regarding postprandial hyperlipidemia in subjects with low TG (<1 mmol/l, <89 mg/dL) or increased TG (>2 mmol/l, >180 mg/dl).
Authors: Genovefa D Kolovou; Dimitri P Mikhailidis; Jan Kovar; Dennis Lairon; Børge G Nordestgaard; Teik Chye Ooi; Pablo Perez-Martinez; Helen Bilianou; Katherine Anagnostopoulou; George Panotopoulos Journal: Curr Vasc Pharmacol Date: 2011-05 Impact factor: 2.719
Authors: Pablo Perez-Martinez; Dolores Corella; Jian Shen; Donna K Arnett; Nikos Yiannakouris; E Syong Tai; Marju Orho-Melander; Katherine L Tucker; Michael Tsai; Robert J Straka; Michael Province; Chew Suok Kai; Francisco Perez-Jimenez; Chao-Qiang Lai; Jose Lopez-Miranda; Marisa Guillen; Laurence D Parnell; Ingrid Borecki; Sekar Kathiresan; Jose M Ordovas Journal: Am J Clin Nutr Date: 2008-12-03 Impact factor: 7.045
Authors: K G M M Alberti; Robert H Eckel; Scott M Grundy; Paul Z Zimmet; James I Cleeman; Karen A Donato; Jean-Charles Fruchart; W Philip T James; Catherine M Loria; Sidney C Smith Journal: Circulation Date: 2009-10-05 Impact factor: 29.690
Authors: Mary K Wojczynski; Stephen P Glasser; Albert Oberman; Edmond K Kabagambe; Paul N Hopkins; Michael Y Tsai; Robert J Straka; Jose M Ordovas; Donna K Arnett Journal: Lipids Health Dis Date: 2011-10-18 Impact factor: 3.876