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Association between postprandial triglycerides and coronary artery disease detected by coronary computed tomography
Henrique L Staniak1, Wilson Salgado Filho2, Márcio H Miname2
1Hospital Universitário, University of São Paulo, São Paulo, Brazil; Lipid Clinic Heart Institute (InCor), University of São Paulo Medical School Hospital, São Paulo, Brazil.
Insights
Individuals with coronary artery disease (CAD) show impaired postprandial triglyceride (TG) metabolism, with delayed TG clearance. This association is partly explained by lower HDL cholesterol levels.
Area of Science:
- Cardiovascular Medicine
- Metabolic Research
- Diagnostic Imaging
Background:
- Severe coronary artery disease (CAD) is linked to postprandial triglycerides (TG).
- The association between less severe atherosclerosis and postprandial TG is less understood.
Purpose of the Study:
- To investigate the relationship between postprandial TG and CAD detected via coronary computed tomographic angiography (CTA).
Main Methods:
- 130 patients (85 with CAD, 45 without) underwent an oral fat tolerance test.
- Postprandial lipemia was assessed by measuring TG levels from 0 to 6 hours.
- A longitudinal multivariable linear mixed effects model analyzed TG changes over time.
Main Results:
- Patients with CAD exhibited slower postprandial TG clearance between 4 and 6 hours (p<0.05).
- This finding persisted after adjusting for fasting TG, glucose, age, sex, BMI, and waist circumference.
- The significance was lost after adjusting for fasting HDL-C.
Conclusions:
- Mild to moderate CAD, detected by coronary CTA, is associated with impaired postprandial metabolism and delayed TG clearance.
- Lower HDL-C partially explained this association.
- Postprandial TG may contribute to CAD development, but this link is partly mediated by low HDL-C.
Background:
Studies have demonstrated the association of severe anatomical coronary artery disease (CAD) with postprandial triglycerides (TG) concentrations. Nevertheless the relationship between less severe atherosclerosis plaque burden and postprandial TG is less established.
Objective:
to study the relationship between postprandial TG and CAD detected by coronary computed tomographic angiography (CTA).
Material And Methods:
130 patients who underwent an oral fat tolerance test were enrolled (85 with CAD detected by CTA and 45 without). Postprandial lipemia was studied by measuring TG from T0h to T6h with 2-h intervals, and analyzed the TG change over time using a longitudinal multivariable linear mixed effects model with the log normal of the TG as the primary outcome.
Results:
The majority of individuals with CAD had non-obstructive disease (63.3%) Patients with CAD had a slower clearance of postprandial TG change from 4 h to 6 h (p<0.05) compared to patients without CAD. These results remained significant after adjustment for fasting TG and glucose, age, gender, body mass index, and waist circumference. However, those differences did not reach statistical significance after adjustment for fasting HDL-C.
Conclusion:
Patients with mild (<25% lumen obstruction) and moderate CAD (25-50% lumen obstruction) detected by coronary CTA had an impaired postprandial metabolism, with a delayed TG clearance, when compared to individuals with no CAD. This difference was partially explained by the lower HDL-C. Thus, though postprandial TG may contribute to the development of CAD, this association is partially related to low HDL-C.
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