Gender difference in postprandial lipemia - Importance of visceral adiposetissue accumulation

Insulin resistance, hyperinsulinemia, hypertriglyceridemia, and low HDL-cho lesterol concentrations are common features of a plurimetabolic syndrome,wh ich increases the risk of coronary artery disease. Although it has been pro posed that the development of atherosclerosis through alterations in plasma lipid levels could be a postprandial phenomenon, most studies on gender di fferences in plasma lipoprotein-lipid concentrations have reported fasting levels. Therefore, the aim of our study was to examine the response of post prandial triglyceride-rich lipoproteins to a standardized meal in 63 men an d 25 women. In addition to the measurement of Fasting and postprandial plas ma lipid levels, numerous physical and metabolic variables were assessed, i ncluding body composition by underwater weighing and body fat distribution by computed tomography. Although no gender difference was noted in total bo dy fat mass, men were characterized by a preferential accumulation of abdom inal adipose tissue as revealed by an increased waist circumference and a g reater visceral adipose tissue accumulation (50% difference) compared with women (P<0.001). Men also showed a greater plasma triglyceride response (P< 0.005) as well as increased postprandial insulin and free fatty acid levels compared with women (P<0.01). Visceral adipose tissue was significantly as sociated with the postprandial triglyceride response in both genders (men: r=0.49, P<0.0001; women: r=0.43, P<0.05). Finally, when men and women were matched for visceral adipose tissue accumulation, the gender difference in postprandial plasma triglyceride response was eliminated, Thus results of t he present study suggest that the well known gender difference in visceral adipose tissue accumulation is an important contributing factor involved in the exaggerated postprandial triglyceride-rich lipoprotein response noted in men compared with women.