Hypertriglyceridaemia, postprandial lipaemia and non-HDL cholesterol

Area of Science:

• Cardiovascular Science
• Lipid Metabolism
• Atherosclerosis Research

Background:

• Elevated total cholesterol (TC), LDL-C, HDL-C, and TG are linked to atherosclerotic vascular disease (AVD) and cardiovascular (CV) events.
• The predictive value of high TG for coronary artery disease (CAD) diminishes in multivariate analyses, particularly after adjusting for HDL-C.
• The intricate relationship between TG and HDL-C, influenced by factors like postprandial lipemia (PPL), remains incompletely understood.

Purpose of the Study:

• To review the complex interplay between triglycerides (TG), postprandial lipemia (PPL), and postprandial hyperlipidemia.
• To examine the potential role of these factors in atherogenesis and cardiovascular disease (CVD).
• To discuss the implications for cardiovascular risk assessment, considering fasting versus non-fasting lipid measurements.

Main Methods:

• Literature review focusing on TG, PPL, postprandial hyperlipidemia, and non-HDL-C.
• Analysis of the relationship between these lipid parameters and their predictive value for CVD.
• Examination of lipoprotein heterogeneity and its impact on atherogenicity.

Main Results:

• Hydrolysis of TG by lipoprotein lipase alters HDL subclasses during PPL.
• TG-transporting lipoproteins (chylomicrons, VLDL, remnants) are heterogeneous and may vary in atherogenicity.
• Alterations in lipoprotein concentration and composition during PPL, termed "postprandial hyperlipidemia," may contribute to CVD development.

Conclusions:

• The relationship between TG, HDL-C, and PPL is complex and significant for understanding CVD risk.
• Current CVD risk assessment relies on fasting lipid levels, potentially overlooking the impact of postprandial changes.
• Further research into TG metabolism during PPL and its atherogenic potential is warranted for improved risk prediction.