Braun D, Gramlich A, Brehme U, Kahle P F, Schmahl F W
Department of Occupational and Social Medicine, University of Tübingen, Germany.
J Cardiovasc Risk. 1997 Apr;4(2):143-9.
The role of triglycerides as a risk factor for coronary artery disease (CAD) is controversial. In prospective studies, which have reported discrepant results, triglycerides have generally been measured with subjects in the fasting state. Taking into account the fact that the average person spends up to 18 h per day in the post-prandial state, fasting triglyceride levels alone are inadequate to describe the actual effective concentrations, metabolism and atherogenicity of triglyceride-rich lipoproteins. Therefore, investigations of the dynamic post-prandial triglyceride metabolism of patients with CAD in comparison with healthy controls are necessary.
We studied the post-prandial metabolism of lipids in 99 men: 50 male patients with CAD confirmed by angiography and 49 matched healthy men. After an overnight fast of 12 h, the subjects (aged 40-60 years) ate a standardized oral fat load (3.2 MJ; 49 g fat = 58% of the total energy content). Blood samples for lipid analyses were drawn immediately prior to and hourly during the 6 h period after ingestion of the meal.
As required by the study design, fasting triglyceride and total cholesterol levels did not differ between patients and controls; however, high-density lipoprotein (HDL), HDL2 and HDL3 cholesterol levels were significantly lower in the CAD patients. The highest post-prandial triglyceride serum concentrations were observed 3 h after ingestion of the oral fat load both in cases and in controls. Generally, CAD patients had slightly higher triglyceride values than did controls and, at the 5 h measurement point, this difference was significant.
The results suggest that there are differences in triglyceride metabolism between patients with CAD and healthy controls after a challenge with a moderate amount of fat. These differences can best be observed in the degradation phase of post-prandial lipaemia.
甘油三酯作为冠状动脉疾病（CAD）的危险因素，其作用存在争议。在前瞻性研究中，结果存在差异，甘油三酯通常是在受试者空腹状态下进行测量的。考虑到普通人每天处于餐后状态的时间长达18小时，仅空腹甘油三酯水平不足以描述富含甘油三酯脂蛋白的实际有效浓度、代谢及致动脉粥样硬化性。因此，有必要对CAD患者与健康对照者餐后甘油三酯的动态代谢进行研究。
我们研究了99名男性的餐后脂质代谢情况：50名经血管造影证实患有CAD的男性患者和49名匹配的健康男性。在12小时的夜间禁食后，受试者（年龄40 - 60岁）食用标准化口服脂肪负荷（3.2兆焦耳；49克脂肪 = 总能量的58%）。在进食后6小时内，于进食前即刻及每小时采集血样进行脂质分析。
按照研究设计要求，患者与对照组的空腹甘油三酯和总胆固醇水平无差异；然而，CAD患者的高密度脂蛋白（HDL）、HDL2和HDL3胆固醇水平显著较低。在摄入口服脂肪负荷后3小时，病例组和对照组均观察到餐后甘油三酯血清浓度最高。一般来说，CAD患者的甘油三酯值略高于对照组，在5小时测量点，这种差异具有显著性。
结果表明，在给予适量脂肪刺激后，CAD患者与健康对照者的甘油三酯代谢存在差异。这些差异在餐后血脂的降解阶段最易观察到。
