Institute for Diagnosis and Treatment of Lipid Disorders and Atherosclerosis (ATHOS), Vienna, Austria.
Thromb J. 2012 Sep 3;10(1):19. doi: 10.1186/1477-9560-10-19.
Postprandial hyperlipidemia and hyperglycemia have been related to cardiovascular events. Among different underlying mechanisms platelet activation seems to be responsible too. No comparable data between various tests in normo- vs. hyperlipidemics before and at different time intervals are available after a fat meal. We aimed to compare 9 of them within the same patients at several time points in postprandial hyperlipidemia.
For some tests baseline values between the groups were significantly different (TXB2, platelet sensitivity, sedimentation and WU-test). However, hyperlipidemia revealed a variable influence on the tests examined. Some of the available tests apparently sensitive to show platelet activation reflect the increase in triglycerides (TG), such as the sedimentation index. ADP-induced platelet aggregatory activity in count adjusted washed isolated platelet samples during postprandial hyperlipidemia indicates mildly enhanced platelet activity, but does not seem to induce significant changes in aggregation. In patients with severe hypertriglyceridemia (> 400 mg/dl fasting) changes in platelet function are more pronounced due to delayed decay and may last up to 16 hours paralleling TG reaching the prevalue. The overwhelming majority of platelet function tests do not significantly respond to postprandial hyperlipidemia. The correlation between the tests applied is poor. For standardization purpose, platelet aggregation tests, aimed to examine proaggregatory capacity in atherosclerosis, should only be performed at the same time of the day after a fasting period > 6 hours. The great variation in preanalytical work-up on comparison of various tests, large number of platelet tests available and their respective potential value are discussed.
At present, the suspicion that platelet function is significantly activated in the postprandial period cannot be supported by any of the tests used. The information provided is valuable to know for which test and group of patients a fasting period of which duration is recommendable.
餐后高血糖和高血脂与心血管事件有关。在不同的潜在机制中，血小板激活似乎也起作用。在进食脂肪餐后，尚无关于正常血脂和高血脂患者在不同时间间隔内各种检测之间的可比数据。我们的目的是在餐后高血脂症期间，在同一患者的多个时间点比较 9 种检测方法。
对于一些检测，组间的基线值存在显著差异（TXB2、血小板敏感性、沉降和 WU 试验）。然而，高血脂症对所检查的检测方法有不同的影响。一些可用的测试显然对血小板激活敏感，反映了甘油三酯（TG）的增加，例如沉降指数。在餐后高血脂症期间，计数调整的洗涤分离血小板样本中 ADP 诱导的血小板聚集活性表明血小板活性轻度增强，但似乎不会引起聚集的显著变化。在严重高甘油三酯血症（空腹 > 400mg/dl）患者中，由于延迟衰减，血小板功能的变化更为明显，可持续至 16 小时，与 TG 恢复到预值平行。绝大多数血小板功能检测对餐后高血脂症没有明显反应。应用的测试之间相关性较差。为了标准化目的，旨在检查动脉粥样硬化中促聚集能力的血小板聚集试验应仅在禁食期 > 6 小时后同一天进行。对比较各种检测方法的预分析工作的巨大差异、大量可用的血小板检测及其各自的潜在价值进行了讨论。
目前，没有任何一种检测方法可以支持血小板功能在餐后明显激活的假设。所提供的信息对于了解哪种检测方法和患者群体需要禁食多长时间是有价值的。
