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Fasting and postprandial hypertriglyceridemia (HTG) depends on increased production of intestinal triglyceride rich lipoproteins in patients with isolated fasting hypertriglyceridemia.
The objective of this study is to compare the serum apoB48 rate after a standardized load test, among patients with isolated hypertriglyceridemia and patients with metabolic syndrome.
Two major studies in 2007 showed that the occurrence of myocardial infarction and death was more frequent in subjects with the highest "non-fasting" triglycerides level. This is an important point that supports the hypothesis that the development of atheromatous lesions also depends on "remnant" of triglyceride-rich lipoproteins (TRL) products such as chylomicrons in the intestine. The elevation of triglycerides in postprandial period depends on the intestinal production of TRL that can be excessively increased as has been shown in diabetes. Accordingly, it is necessary to distinguish between hepatic and intestinal production of TRL in hypertriglyceridemic patients particularly during postprandial period. TRL contain a single molecule of apolipoprotein B (apoB), apoB100 when produced by the liver or apoB-48 when they are produced by the gut. It is well known that apo B100 is the lipoprotein of the VLDL which is increased in hypertriglyceridemia. But preliminary works showed that fasting concentrations of apoB48 were correlated with triglycerides in some hypertriglyceridemic patients. These results suggest an intestinal part in fasting triglycerides levels. It therefore appears that the liver and intestine contribute to hypertriglyceridemia, but the intestinal part is not established particularly in isolated hypertriglyceridemia. The detection of abnormalities in the production of LRT would consider intestinal bowel as a target organ for the initiation of specific lipid-lowering therapy.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Isolated HTG without metabolic syndrome | Experimental | Postprandial test : The preparation used for this test consists of a semi standardized liquid meal (400 ml energy drink Fresubin® 2 cal / ml, Fresenius Kabi, France), containing 800 kcal, 50% calories from carbohydrates, 15% in as protein, and 35% as lipid. The test meal will be performed in the morning during 6 hours (between 8:00 and 14:00) after 10 hours of fasting. |
|
| HTG with metabolic syndrome | Experimental | Postprandial test : The preparation used for this test consists of a semi standardized liquid meal (400 ml energy drink Fresubin® 2 cal / ml, Fresenius Kabi, France), containing 800 kcal, 50% calories from carbohydrates, 15% in as protein, and 35% as lipid. The test meal will be performed in the morning during 6 hours (between 8:00 and 14:00) after 10 hours of fasting. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Postprandial test | Other | Postprandial test : The preparation used for this test consists of a semi standardized liquid meal (400 ml energy drink Fresubin® 2 cal / ml, Fresenius Kabi, France), containing 800 kcal, 50% calories from carbohydrates, 15% in as protein, and 35% as lipid. The test meal will be performed in the morning during 6 hours (between 8:00 and 14:00) after 10 hours of fasting. This post prandial test is the same in the two study groups. |
| Measure | Description | Time Frame |
|---|---|---|
| Apo B48 plasma concentration | Area under the Apo B48 (g/L) plasma concentration (g/L) measured every hour for 6 hours versus time curve (AUC). | every hour for 6 hours (day of sampling after postprandial test) |
| Measure | Description | Time Frame |
|---|---|---|
| Apo B48 peak plasma concentration | Apo B48 (g/L) peak plasma concentration (Cmax) | the highest level of Apo B48 during the test of 6 hours (day of sampling after postprandial test) |
| Measure | Description | Time Frame |
|---|---|---|
| Apo B100 plasma concentration | Area under the Apo B100 (g/L) plasma concentration (g/L) measured every hour for 6 hours versus time curve (AUC). | every hour for 6 hours (day of sampling after postprandial test) |
| Apo B100 peak plasma concentration |
Inclusion criteria :
Inclusion in the metabolic syndrome group if :
Inclusion in isolated hypertriglyceridemia group: patients not having the criteria of the group "metabolic syndrome"
Exclusion criteria :
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| Name | Affiliation | Role |
|---|---|---|
| Philippe Giral, MD | Assistance Publique - Hôpitaux de Paris | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Pitié Salpetriere Hospital | Paris | 75013 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 25332284 | Background | Giral P, Simon D, Chapman MJ. Letter by Giral et al regarding article, "lipoprotein(a) concentrations, rosuvastatin therapy, and residual vascular risk: an analysis from the JUPITER trial (justification for the use of statins in prevention: an intervention trial evaluating rosuvastatin)". Circulation. 2014 Oct 21;130(17):e151. doi: 10.1161/CIRCULATIONAHA.114.009590. No abstract available. |
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| ID | Term |
|---|---|
| D015228 | Hypertriglyceridemia |
| D024821 | Metabolic Syndrome |
| ID | Term |
|---|---|
| D006949 | Hyperlipidemias |
| D050171 | Dyslipidemias |
| D052439 | Lipid Metabolism Disorders |
| D008659 | Metabolic Diseases |
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|
Apo B100 (g/L) peak plasma concentration (Cmax)
| the highest level of Apo B100 during the test of 6 hours |
| Triglycerides peak plasma concentration | Triglycerides (g/L) peak plasma concentration (Cmax) | The highest level of triglycerides during the test of 6 hours |
| Glycemia plasma concentration | Area under the glycemia plasma concentration (mmol/L) measured every hour for 6 hours versus time curve (AUC) | every hour for 6 hours |
| Glycemia peak plasma concentration | Glycemia (mmol/L/L) peak plasma concentration (Cmax) during the postprandial test | the highest level of glycemia during the 6-hours postprandial test |
| D009750 |
| Nutritional and Metabolic Diseases |
| D007333 | Insulin Resistance |
| D006946 | Hyperinsulinism |
| D044882 | Glucose Metabolism Disorders |