Postprandial lipemia and associated metabolic disturbances in healthy and hyperlipemic postmenopausal women

The increased risk for coronary artery disease observed in postmenopausal w omen is partly explained by a more atherogenic fasting lipoprotein profile. Moreover, natural menopause has been associated with an altered postprandi al lipid profile. To better characterize the interaction between fasting an d postprandial lipid profile after menopause, we examined postprandial chan ges in several lipid parameters in three age-matched groups of postmenopaus al women (16 affected by mixed hyperlipemia, 17 by common hypercholesterole mia. and 17 normolipemic), who underwent a standardized oral fat-loading te st. The magnitude of postprandial lipemia, expressed as 8-hour triglyceride incremental area under the curve, was greater in women with mixed hyperlip emia (1,326 +/- 372 mg (.) dL(-1) (.) h(-1)) than in normal (484 +/- 384 mg (.) dL(-1 .) h(-1)) and hypercholesterolemic (473 +/- 223 mg dL(-1 .) h(-1 ); both P <.0001) women, and the differences held after adjustment for body mass index and fasting insulin. Women with mixed hyperlipemia showed a sig nificant postprandial decrease in high density lipoprotein 2 (HDL2) cholest erol, lipoprotein (a), and low-density lipoprotein (LDL) particle size. Bat h hypercholesterolemic and normolipemic women showed a significant postpran dial decrease in HDL cholesterol and lipoprotein (a) levels but not in LDL size. In a multiple linear regression analysis, fasting triglyceride levels , insulin level, and waist hip ratio were all independent predictors of the magnitude of postprandial lipemia. in conclusion, postmenopausal women wit h mixed hyperlipemia show a greater postprandial triglyceride increase and a more pronounced reduction in HDL cholesterol level and LDL size than hype rcholesterolemic and normolipemic subjects. The presence of the features of insulin resistance syndrome could contribute to the deterioration of postp randial lipemic response in these subjects. Copyright (C) 2001 by W.B. Saun ders Company.