title: Assessment and clinical relevance of non-fasting and postprandial triglycerides: an expert panel statement.
abstract: An Expert Panel group of scientists and clinicians met to consider several aspects related to non-fasting and postprandial triglycerides (TGs) and their role as risk factors for cardiovascular disease (CVD). In this context, we review recent epidemiological studies relevant to elevated non-fasting TGs as a risk factor for CVD and provide a suggested classification of non-fasting TG concentration. Secondly, we sought to describe methodologies to evaluate postprandial TG using a fat tolerance test (FTT) in the clinic. Thirdly, we discuss the role of non-fasting lipids in the treatment of postprandial hyperlipemia. Finally, we provide a series of clinical recommendations relating to non-fasting TGs based on the consensus of the Expert Panel: 1). Elevated non-fasting TGs are a risk factor for CVD. 2). The desirable non-fasting TG concentration is <2 mmol/l (<180 mg/dl). 3). For standardized postprandial testing, a single FTT meal should be given after an 8 h fast and should consist of 75 g of fat, 25 g of carbohydrates and 10 g of protein. 4). A single TG measurement 4 h after a FTT meal provides a good evaluation of the postprandial TG response. 5). Preferably, subjects with non-fasting TG levels of 1-2 mmol/l (89-180 mg/dl) should be tested with a FTT. 6). TG concentration ≤ 2.5 mmol/l (220 mg/dl) at any time after a FTT meal should be considered as a desirable postprandial TG response. 7). A higher and undesirable postprandial TG response could be treated by aggressive lifestyle modification (including nutritional supplementation) and/or TG lowering drugs like statins, fibrates and nicotinic acid.
authors.affiliation: Cardiology Department, Onassis Cardiac Surgery Center, 356 Sygrou Avenue, 17674 Athens, Greece. genovefa@kolovou.com
authors.forename: Genovefa D
authors.initials: GD
authors.lastname: Kolovou
authors.forename: Dimitri P
authors.initials: DP
authors.lastname: Mikhailidis
authors.forename: Jan
authors.initials: J
authors.lastname: Kovar
authors.forename: Dennis
authors.initials: D
authors.lastname: Lairon
authors.forename: Børge G
authors.initials: BG
authors.lastname: Nordestgaard
authors.forename: Teik Chye
authors.initials: TC
authors.lastname: Ooi
authors.forename: Pablo
authors.initials: P
authors.lastname: Perez-Martinez
authors.forename: Helen
authors.initials: H
authors.lastname: Bilianou
authors.forename: Katherine
authors.initials: K
authors.lastname: Anagnostopoulou
authors.forename: George
authors.initials: G
authors.lastname: Panotopoulos
mesh_terms: D000818:Animals; D002318:Cardiovascular Diseases / Q000209:etiology; D004041:Dietary Fats / Q000008:administration & dosage*; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D015228:Hypertriglyceridemia / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D000960:Hypolipidemic Agents / Q000494:pharmacology; D008019:Life Style; D019518:Postprandial Period; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood*
chemical_list: D004041:Dietary Fats; D000960:Hypolipidemic Agents; D014280:Triglycerides