Metabolic and lifestyle determinants of postprandial lipemia differ from those of fasting triglycerides - The Atherosclerosis Risk in Communities (ARIC) study

Despite the reported association of lipoprotein responses to a fatty meal w ith atherosclerosis, little is known about the determinants of these respon ses. Plasma triglyceride, retinyl palmitate, and apolipoprotein B-48 respon ses to a standardized fatty meal containing a vitamin A marker were measure d in 602 Atherosclerosis Risk in Communities (ARIC) study participants. To focus on postprandial responses specifically, which have been reported to b e related to atherosclerosis independently of fasting triglycerides, analys es for determinants of postprandial responses were adjusted for fasting tri glycerides. Major determinants of fasting triglycerides, namely, diabetes, obesity, other factors related to insulin resistance, and male sex, were no t independently associated with postprandial responses. Fasting triglycerid es were the strongest predictor of postprandial lipids, but independent of triglycerides, the predictors of postprandial responses were smoking, diet, creatinine, and alcohol, Smokers had substantially increased retinyl palmi tate and apolipoprotein B-48 responses, indicators of chylomicrons and thei r remnants. Persons who consume more calories or omega3 fatty acids had red uced chylomicron responses, Triglyceride responses were associated positive ly with serum creatinine levels and negatively with moderate alcohol consum ption. Thus, determinants of fasting and postprandial lipids differ. The in dependent atherogenic influence of postprandial lipids may relate more to s moking and diet than to obesity and insulin resistance.