Given the potential role of postprandial lipoprotein-lipid metabolism in cardiovascular disease incidence, Coutinho et al. sought to evaluate whether lipid changes in the postprandial period were associated with inflammation changes in subjects with or without type 2 diabetes. For that purpose, an oral lipid tolerance test was performed in 28 control participants and 17 diabetic patients. Blood samples were drawn before, 3 hours after, and 5 hours after the oral fat load. In both groups, triglyceride levels almost doubled 3 hours after the fat load and were even higher after 5 hours. Inflammation, estimated either by white blood cell count (WBC) or plasma C-reactive protein (CRP) levels, also increased during the postprandial period, although to a much lesser extent than triglycerides. HDL cholesterol levels decreased by approximately 10-15% at 5 hours. Changes in triglyceride levels, WBC, and HDL cholesterol levels appeared to be similar in control participants and patients with type 2 diabetes. Changes in CRP levels after the fat load were also similar in both groups. In patients with diabetes, the percent changes in HDL cholesterol levels at 5 hours were inversely associated with waist circumference (r=-0.64, p=0.005), suggesting that abdominally obese, type 2 diabetic patients experience a significant drop in HDL cholesterol levels during the postprandial period. Although no association was found between changes in inflammatory markers and changes in lipids, the study’s authors concluded that the decrease in HDL cholesterol levels after the fat load could represent another feature of the metabolic syndrome.
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