An improved method for the rapid assessment of persisting chylomicron remnant concentrations

Persisting chylomicron remnant concentrations have been linked to premature atherosclerosis. The analysis of persisting chylomicron remnant concentrat ions by an oral triglyceride tolerance test, however, is time-consuming for the study subjects and requires large resources in the laboratory. Therefo re, only small numbers of subjects have been studied in the past. We describe major improvements of the testing procedure in regard of compos ition of the fatty meal, of patient testing, and measurement of postprandia l remnants. Shifting the time of the (ready-to-use) fatty drink from the mo rning hours to bedtime was well accepted by the study subjects and allowed the analysis of blood samples drawn at the morning with minimal impact on t he participants' time and with minimal interferences by confounding factors (e.g. smoking, additional food intake, physical activity). Chylomicron rem nants were measured by fluorometry of the supernatant after ultracentrifuga tion. This procedure was sensitive, was specific for chylomicron remnants, and was easy to perform. The biological validity of the improved procedure was evaluated by studying type III hyperlipoproteinemia patients and normol ipemic apolipoprotein (Apo) E2 homozygotes. In conclusion, this improved test permits the rapid testing for persisting chylomicron remnants in the clinical routine and in large epidemiological s tudies. (C) 2001 The Canadian Society of Clinical Chemists. All rights rese rved.