Postprandial Hypertriglyceridemia Following a Single High-Fat Meal in Patients with Coronary Artery Disease and Normal Subjects: The Significance of the Postprandial Hypertriglyceridemia and the Effects of Fibrate on the Postprandial Hypertriglyceridemia

BACKGROUND AND OBJECTIVES: It has been recently reported that coronary artery disease (CAD) is more correlated with postprandial triglyceride (TG) levels than fasting TG levels. We performed this study to compare the patients with CAD to age- and sex-matched controls in regard to postprandial TG levels and to know the effects of fenofibrate on postprandial TG levels. MATERIALS AND METHOD: Serum TG, total cholesterol (C), HDL-C and LDL-C were measured before, and 2, 4, 6, 8, and 24 hours after a high-fat meal in 22 patients (mean: 60 yr) with CAD and 12 normal subjects (mean: 54 yr). The same parameters were also serially measured after the high-fat meal plus fibrate in 10 patients with CAD (mean: 59 yr). RESULTS: he patients group without fibrate showed that more prolonged and exaggerated hypertriglyceridemia following the meal than normal subjects, especially 4 to 8 hours after the meal and that lower HDL-C throughout the test duration. These changes were also persisted when hyperlipidemic patients were excluded out of the patients group. The patients with fibrate did not show such a significant elevation of TG levels 4 to 8hours after the meal compared when normal subjects. The time to reach the peak TG levels after the meal was 4, 6, and 4 hours after the meal in normal subjects, patients with CAD, and fibrate group, respectively. CONCLUSION: Coronary artery disease is clearly related with postprandial hypertriglyceridemia than fasting TG levels and postprandial hypertriglyceridemia can be somewhat prevented by fibrate.

The Effect of Vitamin E on the Endothelial Function Following a Single High-Fat Meal in Normal Subjects, Patients with Coronary Heart Disease and Patients with Diabetes

BACKGROUND AND OBJECTIVES: The hyperlipidemia by a high-fat diet induce the endothelial dysfunction. We have performed this study to determine the relationship between postprandial hypertriglyceridemia and endothelial function and to know the effects of vitamin E on the endothelial function. MATERIALS AND METHOD: Endothelial function was measured by flow-mediated brachial artery vasodilation (FMD) as percent diameter changes. We have serially measured lipid profiles and FMD after a meal in normal subjects (10 males, mean:26 yr), which test was repeated according to types of meal (high-fat, low-fat and high-fat meal with 800 IU vitamin E). The second stage of this study is consisted of 10 patients with coronary artery disease (CAD, mean:50 yr) and 10 diabetes (DM, mean:48 yr). RESULTS: The serum triglycerides were significantly increased at 2 and 4 hours after a high-fat meal. The FMD was transiently decreased (p<0.001) to 7+/-4% and 7+/-2% at 2 and 4 hours only after a high-fat meal from 13+/-4% at fasting state. The FMD was inversely related with postprandial hypertriglyceridemia (r=0.52, p<0.05). The baseline FMD in patients with CAD and DM were all lower, 9+/-4% and 10+/-5% respectively, than 15+/-2% of normal subjects. The FMD in patients with CAD were improved to 13+/-4%, 13+/-4% and 11+/-6% at 2, 4, and 6 hours after a meal plus vitamin E, respectively. The FMD in diabetic patients were not decreased as same manor in normal subjects. CONCLUSION: The vitamin E can prevent the endothelial dysfunction which is induced by postprandial hypertriglyceridemia in normal subjects and can improve the endothelial dysfunction in patients CAD as well as DM.