Comparison of different methods to investigate postprandial lipaemia

Postprandial hyperlipidaemia has been associated with coronary artery disease (CAD). We investigated which of the generally used methods to test postprandial lipaemia differentiated best between patients with premature CAD (50 +/- 4 years, n=20) and healthy controls. Furthermore, the effects of rosuvastatin 40 mg/day on postprandial parameters were assessed. Standardised oral fat-loading tests (OFLT) and ambulant self-measurements of daylong capillary triglycerides (TGc) were performed. Total responses of individual lipoproteins, plasma TG (TGp) and remnant-like particle cholesterol (RLP-C) were estimated as area under the curve (AUC). Most AUCs were highest in untreated patients and reached control levels after rosuvastatin. From all AUCs, RLP-C-AUC was best associated to TGp-AUC in untreated patients and controls (adjusted R(2)=0.84, beta=0.92, P <0.001). From all parameters of postprandial lipaemia, TGc-AUC differentiated best between untreated patients and controls (adjusted R(2)=0.48, beta=0.70, p <0.0001) and between patients on and off-treatment (adjusted R(2)=0.34, beta=0.60, p <0.0001). Our findings indicate that the real-life TG load, instead of metabolic ward testing, is the best parameter of postprandial lipaemia to identify patients with premature coronary sclerosis and to evaluate postprandial effects of statin treatment