Post-prandial hypertriglyceridemia in patients with type 2 diabetes mellitus with and without macrovascular disease.

OBJECTIVES: To study the postprandial hypertriglyceridemia in patients with type 2 diabetes mellitus with and without macrovascular disease.

METHODS: Postprandial lipids were studied in 13 type 2 diabetic subjects with macrovascular disease (group I), 13 diabetic subjects without macrovascular disease (group II) and 13 age, sex and BMI matched healthy controls (group III) after an oral fat challenge which consisted of meal providing 729 kcal/m2 body surface area with 65.2 g fat.

RESULTS: All the three groups were age, sex and BMI matched. Average duration of diabetes was not significantly different between both the diabetic groups. Waist-hip ratio (WHR) was significantly more in group I and II as compared to group III. Also group I displayed significantly higher WHR than group II. Fasting total cholesterol and LDL levels were significantly higher in group I compared to group III. Fasting HDL was significantly lower in both group I and II vs group III. Fasting TG was not significant between any of the three study groups. Significant postprandial hypertriglyceridemia was observed in group I and group II compared to group III. When area under curves (iAUC) for different lipid parameters were adjusted for their respective fasting values, it was observed that only iAUC TG and iAUC VLDL remained significantly higher in group I and group II as compared to group III. Postprandial triglyceride levels at 6 and 8 hours in group I were significantly higher as compared to group III. Postprandial HDL-C levels at 6 and 8 hours were significantly lower group I and II as compared to group III. Postprandial triglyceride parameters showed significant correlation with fasting triglyceride in group I and II and no significant correlation was found with any of the anthropometric, glycemic and insulin resistance measures.

CONCLUSION: This study finds significant postprandial hypertriglyceridemia and significant delay in postprandialtriglyceride clearance following a standardized fat meal challenge in patients with type 2 diabetes mellitus, particularly those with macrovascular disease. Persistent postprandial hypertriglyceridemia may result in a pro-atherogenic environment leading to atherosclerosis and macrovascular disease in type 2 diabetes subjects.