Is abnormal postprandial lipemia a familial risk factor for coronary artery disease in individuals with normal fasting concentrations of triglycerides and cholesterol?

Objective To assess the postprandial response to a fat load in patients wit h coronary artery disease (CAD) and age-matched controls. Methods Postprandial lipemia was assessed in patients with GAD confirmed by angiography (study group, n = 44) and in patients without coronary lesions (control group, n = 20). Family members of patients with CAD were also inc luded (spouses group, n=22; progeny group, n = 33). Pasting triglyceride an d cholesterol concentrations in the control and study groups were less than 2.3 and 6.47 mmol/l, respectively. After initial blood sampling, the patie nts consumed 30% cream (200 ml/m(2) body area). Repeat measurements of trig lycerides, total cholesterol and high-density lipoprotein were made after 2 , 4, 6, and 8 h. Results Changes were most marked in triglyceride concentrations. Peak value s were observed after 4 h in the spouses, progeny, and control groups, and after 6 h in the study group. To compensate for the large age span (8-40 ye ars) of the progeny, two subgroups were formed, taking 25 years as the cut- off value. Triglycerides continued to increase until the 4th hour in both s ubgroups, but the subgroups differed as to the absolute concentration of tr iglycerides. During the first 6 h of the test, the concentrations were sign ificantly greater in the subgroup of older progeny than in their fathers wi th CAD. Conclusions These findings indicate that triglycerides are metabolized at a slower rate and remain longer in the circulation of patients with CAD, as compared with patients without CAD. A significantly greater level of postpr andial lipemia has been observed in adult progeny of patients with CAD, sug gesting a genetic disorder of triglyceride metabolism in these individuals. Coron Artery Dis 11 :377-381 (C) 2000 Lippincott Williams & Wilkins.