Postprandial lipid metabolism in diabetes

Postprandial lipemia is an inherent feature of diabetic dyslipidemia and hi ghly prevalent in diabetic patients even with normal fasting triglyceride c oncentrations. Postprandial lipemia is characterized by long residence time of chylomicron and VLDL remnants in the circulation. Insulin resistance ca uses increased flux of free fatty acids, and thus enhanced VLDL apolipoprot ein B (apo B) synthesis in the liver. Together with chylomicron and VLDL re mnant competition for the common removal mechanisms the increased substrate input results in exaggerated and prolonged postprandial lipemia. Studies u sing both apo B-48 and retinyl esters as a marker for intestinally derived particles have shown that increased postprandial lipemia does not predict t he presence or absence of coronary artery disease between non-insulin-depen dent diabetes mellitus (NIDDM) subjects. Recent data have shown that postpr andial triglyceride-rich remnants are atherogenic, and postprandial hypertr iglyceridemia contributes to the metabolic disturbances transforming LDL an d HDL subclasses into more atherogenic direction in diabetic subjects. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.