Validity of an Abbreviated, Clinically Feasible Test for Postprandial Lipemia in Healthy Adults: A Randomized Cross-Over Study

Abstract

Background: A large post-meal triglyceride (TG) response is an independent risk factor for cardiovascular disease, but postprandial lipemia assessments are not clinically practical in their current form. Therefore, we assessed the validity of an abbreviated, clinically feasible protocol in measuring postprandial lipemia.

Method: Eighteen healthy adults (8 male and 10 female) completed 3 high-fat meal trials in random order: (1) a Standard in Lab (SL) protocol wherein blood draws (to determine TG) were made from a catheter at baseline and hourly for 6 h; (2) an Abbreviated in Lab (AL) protocol in which participants remained in the laboratory but blood draws were only made at baseline and 4 h post-meal; and (3) an Abbreviated with Freedom (AF) protocol in which participants vacated the laboratory between the meal and the 4-h blood draw.

Results: TG increase from baseline was very similar (p = 0.93) across the 3 trials (SL: 68.5 ± 62.7 mg/dL; AL: 71.1 ± 58.0 mg/dL; AF: 66.7 ± 46.4 mg/dL), as were 4-h TG levels (SL: 144.6 ± 84.2 mg/dL; AL: 171.4 ± 88.2 mg/dL; AF: 157.7 ± 76.7 mg/dL; p = 0.49). Similarly, total and incremental area under the curve (AUC) were not significantly different across the trials (p = 0.12 and 0.91, respectively).

Conclusion: The TG results of the clinically feasible, abbreviated protocol were similar to those of the more exhaustive standard protocol. The AF protocol could be a valid and feasible clinical tool for measurement of postprandial lipemia and assessment of cardiovascular risk, although studies in larger and more diverse cohorts are needed.

Keywords: fat tolerance; post-meal; risk assessment; triglycerides.

Figure 1

Protocol for the three meal trials. Participants completed 3 meal trials in random order. The Standard in Lab (SL) trial featured blood draws from a venous catheter at baseline and hourly for 6 h post-meal. The Abbreviated in Lab (AL) trial included single blood draws at baseline and 4 h post-meal, while the participants remained in the lab. In the Abbreviated with Freedom (AF) trial, participants vacated the lab between the meal and the 4-h blood draw.

Figure 2

Postprandial triglyceride responses in the 3 meal trials. For clarity, postprandial triglyceride data are presented in four ways (A–D), varying whether data are normalized for fasting values (Panels B,D) and overlaid with hourly data from the SL trial (Panels C,D). There were no significant differences in the postprandial triglyceride response across the 3 trials. Additionally, “ns” denotes that there was no difference between the 3-h and 4-h triglyceride levels in the SL trial.