Stroke, Vol 23, 823-828, Copyright © 1992 by American Heart Association
JE Ryu, G Howard, TE Craven, MG Bond, AP Hagaman and JR Crouse 3d
BACKGROUND AND PURPOSE: It has been suggested that a postprandial
accumulation of triglyceride-rich lipoproteins promotes the development of
atherosclerosis. This study was designed to test the hypothesis that
postprandial lipemia is independently associated with intima-media
thickening of the extracranial carotid arteries. METHODS: Forty-seven
middle-aged, moderately hypercholesterolemic individuals were recruited for
a 1-day study of the lipemic response to a standard high-fat test meal. The
formula was fed at a dose of 65 g fat/m2 body surface area, after a 14-hour
fast, and blood was obtained for triglyceride analysis hourly for 8 hours.
A baseline lipid profile was obtained. Each subject underwent a carotid
ultrasound examination. The extent of alimentary lipemia (peak triglyceride
response) was correlated with the carotid artery wall thickness as measured
by B-mode ultrasound. RESULTS: Univariate analyses indicated an inverse
correlation between peak triglyceride response and high density lipoprotein
cholesterol concentration and a direct correlation with male sex, baseline
triglyceride concentration, background fat intake, and waist-to-hip ratio.
Of these, the only variable that showed a univariate correlation with
B-mode score was peak triglyceride response. Age and cigarette smoking were
also correlated with B-mode score in univariate analyses. The correlation
coefficient (r = 0.52) between peak triglyceride response to a fat-rich
meal and B-mode score was significant (p less than 0.002) and remained so
in multivariate analysis. Forward-selection stepwise regression resulted in
the inclusion of only peak triglyceride response (p = 0.001) and smoking
history (p = 0.005) as important predictors of carotid wall thickness in a
linear model. CONCLUSIONS: The association between lipemic response and
carotid wall thickness suggests that prolonged exposure of arterial wall
cells to triglyceride- rich chylomicron remnants enhances the atherogenic
process.
ARTICLES
Postprandial triglyceridemia and carotid atherosclerosis in middle-aged subjects
Department of Medicine, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, N.C. 27157-1047.
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