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Extended-release niacin acutely suppresses postprandial triglyceridemia
M Haris U Usman1, Arman Qamar, Ramprasad Gadi
1Department of Medicine, Division of Translational Medicine and Human Genetics, Perelman School of Medicine at the University of Pennsylvania, and the University of Pennsylvania Health System, Philadelphia, PA 19104, USA.
The American Journal of Medicine
|July 31, 2012
Summary
Extended-release niacin taken before a meal significantly reduces postprandial triglycerides by restricting free fatty acids. This acute effect suggests potential for improved cardiovascular event prediction.
Area of Science:
- Cardiovascular disease research
- Pharmacology
- Nutritional science
Background:
- Postprandial triglyceridemia is a known predictor of cardiovascular events.
- Niacin's potential to lower triglycerides is linked to free fatty acid restriction.
- Previous studies showed immediate-release niacin effective, but extended-release niacin ineffective when taken hours before a meal.
Purpose of the Study:
- To investigate if extended-release niacin, when administered shortly before a fat challenge, can suppress postprandial triglycerides.
- To determine the relationship between postprandial triglyceride levels and the restriction of free fatty acids.
Main Methods:
- A double-blinded, placebo-controlled, randomized crossover study.
- Healthy volunteers received 2g of extended-release niacin or placebo 1 hour before consuming heavy cream.
- Blood samples were collected over 12 hours to measure triglycerides and free fatty acids (incremental area under the curve and nadir).
Main Results:
- Extended-release niacin decreased postprandial triglycerides by 33% (P=.02).
- Free fatty acid levels were significantly reduced by extended-release niacin (nadir P<.0001, AUC P=.0015).
- A strong correlation (r = +0.58, P=.0007) was observed between triglyceride reduction and free fatty acid decrease.
Conclusions:
- A single dose of extended-release niacin, taken immediately before a meal, acutely suppresses postprandial triglyceridemia.
- This suppression is likely due to significant free fatty acid restriction.
- Further research is needed to explore mealtime dosing of extended-release niacin for enhanced clinical efficacy.
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