title: Postprandial lipemia and the risk of coronary heart disease and stroke: the Atherosclerosis Risk in Communities (ARIC) Study.
abstract: OBJECTIVE
  Excessive levels of triglyceride-rich lipoproteins during postprandial lipemia (PPL) have been reported to be atherogenic. However, it is unclear whether the degree of PPL independently predicts cardiovascular disease (CVD) given the scarcity of longitudinal data with standardised measures of postprandial change. We reexamined associations of PPL with incident CVD events in a population-based cohort using detailed measures of postprandial change from a standardised fat challenge.
  
  
  METHODS
  Postprandial triglycerides, TG-rich lipoprotein triglycerides, retinyl palmitate and apolipoprotein B48 to B100 ratio were measured before (following a 12-hour fasting period) and after a fat-tolerance test meal in a middle-aged, biracial subcohort without CVD (coronary heart disease (CHD) or stroke) from the community-based Atherosclerosis Risk in Communities (ARIC) Study in 1990-1993. Using these measures, we estimated associations of postprandial change with incident CVD (CHD, stroke) through 2012. Stratified analyses by race, obesity and carotid atherosclerotic severity were also conducted.
  
  
  RESULTS
  Of 559 participants, 127 (23%) developed CHD and 27 (5%) experienced a stroke over more than 20 years of follow-up. None of the measures of postprandial change were associated with incident CVD events in the overall sample, or by subgroups of race, obesity or carotid atherosclerotic severity (all p>0.3).
  
  
  CONCLUSIONS
  The degree of PPL was not shown to predict excess CVD risk in extended follow-up of a population-based sample. While our study is the largest to examine the association between PPL and incident CVD using standardised postfat challenge measures, prospective investigation with similar assessment of PPL in more powered samples is warranted.
authors.affiliation: Department of Epidemiology , Gillings School of Global Public Health, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina , USA.
authors.forename: Dmitry
authors.initials: D
authors.lastname: Kats
authors.affiliation: Department of Epidemiology , Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland , USA.
authors.forename: A Richey
authors.initials: AR
authors.lastname: Sharrett
authors.affiliation: Irving Institute for Clinical and Translational Research, Columbia College of Physicians and Surgeons , New York, New York , USA.
authors.forename: Henry N
authors.initials: HN
authors.lastname: Ginsberg
authors.affiliation: Michael E Debakey Veterans Affairs Hospital, Houston, Texas, USA; Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA; Houston Methodist Debakey Heart and Vascular Center, Houston, Texas, USA.
authors.forename: Vijay
authors.initials: V
authors.lastname: Nambi
authors.affiliation: Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA; Houston Methodist Debakey Heart and Vascular Center, Houston, Texas, USA.
authors.forename: Christie M
authors.initials: CM
authors.lastname: Ballantyne
authors.affiliation: Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA; Houston Methodist Debakey Heart and Vascular Center, Houston, Texas, USA.
authors.forename: Ron C
authors.initials: RC
authors.lastname: Hoogeveen
authors.affiliation: Department of Epidemiology , Gillings School of Global Public Health, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina , USA.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Heiss
keywords: CHD Coronary Heart Disease; Postprandial Lipemia; Stroke; Triglycerides