Abstract
High levels of fasting circulating triglycerides (TG) represent an independent risk factor for cardiovascular disease. In western countries, however, people spend most time in postprandial conditions, with continuous fluctuation of lipemia due to increased levels of TG-rich lipoproteins (TRLs), including chylomicrons (CM), very low density lipoproteins (VLDL), and their remnants. Several factors contribute to postprandial lipid metabolism, including dietary, physiological, pathological and genetic factors. The presence of coronary heart disease, type 2 diabetes, insulin resistance and obesity is associated with higher postprandial TG levels compared with healthy conditions; this association is present also in subjects with normal fasting TG levels. Increasing evidence indicates that impaired metabolism of postprandial lipoproteins contributes to the pathogenesis of coronary artery disease, suggesting that lifestyle modifications as well as pharmacological approaches aimed at reducing postprandial TG levels might help to decrease the cardiovascular risk.
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Declaration of funding
This study was not funded.
Declaration of financial/other relationships
A.P. and G.D.N. have disclosed that they have no significant relationships with or financial interests in any commercial companies related to this study or article. A.L.C. has disclosed that he has received grants from and is a consultant to Merck, AstraZeneca, Amgen, and Sanofi. He has also been a consultant to Pfizer.
CMRO peer reviewer 1 has disclosed that he is the recipient of sponsorship funding to attend meetings on behalf of Merck, Sharpe & Dohme; is a consultant for Merck, Sharpe & Dohme; and is a member of the speakers bureaux for Merck, Sharpe & Dohme and Genzyme. CMRO peer reviewer 2 has no relevant financial or other relationships to disclose.