检测高脂餐后高甘油三酯血症的最佳时间切点

Optimal time point to measure postprandial hypertriglyceridemia after a high-fat meal

目的 研究冠心病患者和高血压病患者高脂餐后甘油三酯 (TG)浓度的变化 ,探讨检测餐后TG代谢的最佳时间切点。方法 5 4例冠心病患者、3 6例高血压病患者和 2 5例健康对照者于禁食 12h后接受高脂餐负荷试验 (总热量 80 0kcal ,其中脂肪 5 0g) ,检测空腹和餐后 2、4、5、7h血清TG浓度。结果在全部研究对象 ,高脂餐后 2 ,4,5h点的血清TG浓度的均显著升高 (均P <0 .0 5 )。与对照组比较 ,高血压病和冠心病患者的餐后TG水平及峰值时间显著延迟 (均P <0 .0 5 )。TG曲线下面积 (AUCTG)在对照者、高血压病患者和冠心病患者依次增高 (均P <0 .0 5 )。高血压病和冠心病患者的AUCTG与餐后 4h血清TG水平增长值的相关性最显著 (均r =0 .94,P <0 .0 0 1)。结论 在高脂餐负荷试验中 ,餐后 4h血清TG水平增长值可作为检测高血压病和冠心病患者餐后血清AUCTG的替代指标。

Objective To study the change of postprandial triglyceride (TG) concentrations after a high-fat meal in patients with coronary heart diseases (CHD), patients with essential hypertension (EHP) and healthy controls, and to explore the optimal time point to measure postprandial TG metabolism. Methods Fifty-four CHD patients, thirty-six EHP patients and twenty-five healthy controls were recruited. The concentrations of serum TG in fasting state and at 2, 4, 5, 7 h after a single high-fat meal (800 kcal, including 50 g fat) were measured. Results The postprandial serum TG concentrations increased significantly at 2, 4, 5 h point in all subjects (all P<0.05). The CHD patients and EHP patients showed significantly higher and prolonged postprandial TG concentrations than the controls did (all P<0.05). The area under TG curve (AUC_ TG ) over 7 h was increased in the order of the controls, the EHP patients and the CHD patients (all P<0.05). The required time to reach peak value of TG was obviously delayed in the CHD patients and EHP patients compared with the controls (P<0.05). AUC_ TG was most obviously correlated with the increment at 4 h serum TG concentrations in the CHD patients and EHP patients (both r=0.94, P<0.001). Conclusion In high-fat meal test, the increment of serum TG concentration at 4 h can be considered as a surrogate of AUC_ TG in CHD and EHP patients.