Charakterisierung und metabolisches Risiko der postprandialen Triglyzeridantwort bei Männern

Zusammenfassung

Hintergrund und Fragestellung Zur metabolischen Risikoeinschätzung hat die postprandiale Triglyzeridantwort (pp TG-Antwort) auf eine orale Fettbelastung neben dem basalen TG-Spiegel an Bedeutung gewonnen. Diese Studie untersucht (i) die Bedeutung von Ernährungszustand und Ernährung für die pp TG-Antwort und vergleicht (ii) die pp TG-Antwort vs. dem basalen TG-Spiegel und (iii) den maximalen pp TG-Spiegel (TG_ppmax) vs. der TG-AUC (area under curve) für die metabolische Risikoeinschätzung. Material und Methodik Bei 100 Männern (44 - 68 Jahre) wurden Ernährungszustand, Ernährung, metabolisches Risiko und pp Lipidstoffwechsel erfasst. Es erfolgte eine Einteilung in Triglyzerid-Normal- (TG_ppmax < 260 mg/dl) und High-Responder (TG_ppmax ≥ 260 mg/dl). Ergebnisse BMI, Fettmasse, Taillenumfang, LDL-C, basale sowie pp-Glukose- bzw. Insulinspiegel und Blutdruck zeigten eine positive und HDL-C sowie Ballaststoffaufnahme eine inverse Korrelation zur pp TG-Antwort. Der basale TG-Spiegel erklärte gegenüber der pp TG-Antwort bei 12 von 14 untersuchten metabolischen Risikofaktoren einen höheren Anteil der Varianz. Die TG-AUC war am engsten zum metabolischen Risiko assoziiert. Schlussfolgerung Übergewicht, eine erhöhte abdominelle Fettmasse und eine geringe Ballaststoffzufuhr waren Determinanten einer erhöhten pp TG-Antwort. Der basale TG-Spiegel wies vs. der pp TG-Antwort eine engere Beziehung zum metabolischen Risiko auf. Dieses Ergebnis steht im Widerspruch zu Untersuchungen an normalgewichtigen jungen Männern und könnte durch Unterschiede in der Fettmasse erklärt sein.

Abstract

Purpose Postprandial triglyceride- (pp TG-) response to an oral lipid load has been suggested as part of metabolic risk assessment. This study analyses (i) the confounding effect of nutritional status and nutrition on pp triglyceride-response and compares (ii) pp TG-response vs. fasting triglyceride level and (iii) postprandial triglyceride peak value vs. triglyceride-AUC (area under curve) with respect to metabolic risk assessment. Material and Methods 100 men (44 - 68 years) were characterised with respect to nutritional status, nutrition, metabolic risk and postprandial lipidmetabolism. The subjects were divided into triglyceride normal- (pp triglyceride peak value < 260 mg/dl) and high-responder (pp triglyceride peak value ≥ 260 mg/dl) Results BMI, fat mass, waist circumference, LDL-C, fasting as well as pp glucose, insulin levels and blood pressure were positively associated, HDL-C and intake of dietary fibre were negatively correlated to pp TG-response. Compared to pp triglyceride-response fasting triglyceride level contributed to a greater explanation of variance in 12 of 14 metabolic risk factors. Triglyceride-AUC was highly correlated to metabolic risk. Conclusion Overweight, elevated abdominal fat mass and low intake of dietary fibre were determinants of increased pp TG-response. Compared to pp TG-response fasting triglyceride level had a stronger association with metabolic risk. This effect is controversial to findings in young normalweight men and could be explained by differences in fat mass.

Schlüsselwörter

postprandiale Triglyzeridantwort - maximaler postprandialer Triglyzeridspiegel - Triglyzerid-AUC - basaler Triglyzeridspiegel - metabolisches Risiko

Key words

postprandial triglyceride-response - postprandial triglyceride peak value - triglyceride-area under curve - fasting triglyceride level - metabolic risk

Literatur

• 1 Durrington P N. Triglycerides are more important in atherosclerosis than epidemiology has suggested.  Atherosclerosis. 1998;  141, Suppl 1 57-62
• 2 Schrezenmeir J, Keppler I, Fenselau S, Weber P, Biesalski H K, Probst R, Laue C, Zuchhold H D, Prellwitz W, Beyer J. The Phenomenon of a High Triglyceride Response to an Oral Lipid Load in Healthy Subjects and its Link to the Metabolic Syndrome.  Annals of the New York Academy of Sciences. 1993;  683 302-314
• 3 Bepperling F, Küntzel C, Metzler B, Kästner P, Schmahl F W. Untersuchung zur Bedeutung von nüchternen und postprandialen Serumlipiden im Rahmen von Risikofaktoren-Analysen.  Aktuelle Ernährungsmedizin. 1988;  13 47-51
• 4 Hodis H N. Triglyceride-Rich Lipoprotein Remnant Particles and Risk of Atherosclerosis.  Circulation, Journal of the American Heart Association. 1999;  99 2852-2854
• 5 Couillard C, Bergeron N, Prud'homme D, Bergeron J, Tremblay A, Bouchard C, Mauriège P, Després J P. Postprandial Triglyceride Response in Visceral Obesity in Men.  Diabetes. 1998;  47 953-960
• 6 Ågren J, Hänninen O, Julkunen A, Fogelholm L, Vidgren H, Schwab U, Pynnönen O, Uusitupa M. Fish diet, fish oil and docosahexaenoic acid rich oil lower fasting and postprandial plasma lipid levels.  European Journal of Clinical Nutrition. 1996;  50 765-771
• 7 Lewis G F, O'Meara N M, Soltys P A, Blackman J D, Iverius P H, Druetzler A F, Getz G S, Polonsky K S. Postprandial lipoprotein metabolism in normal and obese subjects: comparison after the vitamin A fat-loading test.  Journal of Clinical Endocrinology and Metabolism. 1990;  71 1041-1050
• 8 Kolovou G D, Anagnostopoulou K K, Pavlidis A N, Salpea K D, Iraklianou S A, Tsarpalis K, Damaskos D S, Manolis A, Cokkinos D V. Postprandial lipemia in men with metabolic syndrome, hypertensives and healthy subjects.  Lipids in Health and Disease. 2005;  4 21
• 9 Couillard C, Bergeron N, Prud'homme D, Bergeron J, Tremblay A, Bouchard C, Mauriège P, Després J P. Gender Difference in Postprandial Lipemia, Importance of Visceral Adipose Tissue Accumulation.  Arteriosclerosis, Thrombosis and Vascular Biology. 1999;  19 2448-2455
• 10 Tremblay A J, Després J P, Piché M E, Nadeau A, Bergeron J, Alméras N, Tremblay A, Lemieux S. Associations between the fatty acid content of triglyceride, visceral adipose tissue accumulation, and components of the insulin resistance syndrome.  Metabolism. 2004;  53, No. 3 310-317
• 11 Datillo A M, Kris-Etherton P M. Effects of weight reduction on blood lipids and lipoproteins: a meta-analysis.  American Journal of Clinical Nutrition. 1992;  56 320-328
• 12 Wijk J Van, Cabezas M Z, Halkes C, Erkelens D W. Effects of different nutrient intakes on daytime triacylglycerolemia in healthy, normolipemic, free-living men.  American Journal of Clinical Nutrition. 2001;  74 171-178
• 13 Brewster A C, Lankford H G, Schwartz M G, Sullivan J F. Ethanol and Alimentary Lipemia.  American Journal of Clinical Nutrition. 1966;  19 255-259
• 14 Volek J S, Gómez A L, Kraemer M S, Kraemer W J. Fasting Lipoprotein and Postprandial Triacylglycerol Responses to a Low-Carbohydrate Diet Supplemented with n-3 Fatty Acids.  Journal of the American College of Nutrition. 2000;  19, No. 3 383-391
• 15 Cara L, Dubois C, Borel P, Armand M, Senft M, Portugal H, Pauli A, Bernard P, Lairon D. Effects of oat bran, rice bran, wheat fiber and wheat germ on postprandial lipemia in healthy adults.  American Journal of Clinical Nutrition. 1992;  55 81-88
• 16 Müller M J, Bosy-Westphal A, Klaus S, Kreymann G, Lührmann P M, Neuhäuser-Berthold M, Noack R, Pirke K M, Platte P, Selberg O, Steiniger J. World Health Organization equations have shortcomings for predicting resting energy expenditure in persons from a modern, affluent population: generation of a new reference standard from a retrospective analysis of a German database of resting energy expenditure.  American Journal of Clinical Nutrition. 2004;  80 1379-1390
• 17 Matthews D R, Hosker J P, Rudenski A S, Naylor B A, Treacher D F, Turner R C. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man.  Diabetologia. 1985;  28 412-419
• 18 Summers L, Barnes S C, Fielding B A, Beysen C, Ilic V, Humphreys S M, Frayn K N. Uptake of individual fatty acids into adipose tissue in relation to their presence in the diet.  American Journal of Clinical Nutrition. 2000;  71 1470-1477
• 19 Marin P, Rebuffe-Scrive M, Bjorntorp P. Uptake of triglyceride fatty acids in adipose tissue in vivo in man.  European Journal of Clinical Investigation. 1990;  20 (2) 158-165
• 20 Biesalski H K, Fürst P, Kasper H, Kluthe R, Pölert W, Puchstein C, Stähelin H B. Ernährungsmedizin, 2. Auflage. Stuttgart, New York; Georg Thieme Verlag 1999
• 21 Schrezenmeir J, Fenselau S, Keppler I, Abel J, Orth B, Laue C, Stürmer W, Fauth U, Halmagyi M, März W. Postprandial Triglyceride High Response and the Metabolic Syndrome.  Annals of the New York Academy of Sciences. 1997;  827 353-368
• 22 Mamo J CL, Watts G F, Barrett H R, Smith D, James A P, Pal S. Postprandial dyslipidemia in men with visceral obesity: an effect of reduced LDL receptor expression?.  American Journal of Physiology - Endocrinology and Metabolism. 2001;  281 626-632
• 23 Lairon D, Arnault N, Bertrais S, Planells R, Clero E, Hercberg S, Boutron-Ruault M. Dietary fiber intake and risk factors for cardiovascular disease in French adults.  American Journal of Clinical Nutrition. 2005;  82 1185-1194
• 24 Harris W S, Connor W E, Alam N, Illingworth D R. Reduction of postprandial triglyceridemia in humans by dietary n-3 fatty acids.  Journal of Lipid Research. 1988;  29 1451-1460
• 25 The Report of the British Nutrition Task Force .Cardiovascular Disease, Diet, Nutrition and Emerging Risk Factors. chaired by Professor Keith N. Frayn. In: Stanner S (ed) Blackwell Publishing for the British Nutrition Foundation 2005
• 26 Mittendorfer B, Sidossis L S. Mechanism for the increase in plasma triacylglycerol concentrations after consumption of short-term, high-carbohydrate diets.  American Journal of Clinical Nutrition. 2001;  73 892-899
• 27 Kolovou G D, Anagnostopoulou K K, Pilatis N, Kalfaltis N, Sarodila K, Psarros E, Cokkinos D V. Low fasting low high-density lipoprotein and postprandial lipemia.  Lipids in Health and Disease. 2004;  3 8
• 28 Kolovou G D, Daskalova D C, Iraklianou S A, Adamopoulou E N, Pilatis N D, Hatzigeorgiou G C, Cokkinos D V. Postprandial Lipemia in Hypertension.  Journal of the American College of Nutrition. 2003;  22, No. 1 80-87