Sustained postprandial decrease in plasma levels of LDL cholesterol in patients with type-2 diabetes mellitus

Research output: Contribution to journalJournal articleResearchpeer-review

  • S.S. Lund
  • Martin Petersen
  • M. Frandsen
  • U.M. Smidt
  • Hans-Henrik Dyring Parving
  • A.A. Vaag
  • T. Jensen

Objective. Low density lipoprotein cholesterol (LDL-C) is an independent and modifiable risk factor for

development of cardiovascular disease (CVD). Postprandial lipid metabolism has been linked to CVD, but little

is known about the postprandial LDL-C profile in patients with type-2 diabetes (T2DM). We aimed to study the

postprandial levels of LDL-C in T2DM patients. Material and methods. After an overnight fast, 74 T2DM

patients, mean age approximately 60 years, were served a standard fat-rich meal of 3,515 kJ containing 54 % fat,

13 % protein and 33 % carbohydrates. Only drinking water was allowed postprandially. Blood samples were

drawn at times 0 (fasting), 1.5, 3.0, 4.5 and 6.0 h (postprandial). In all samples, LDL-C was measured with

modified beta quantification (separation by ultracentrifugation followed by measurement of infranate high

density lipoprotein cholesterol (HLD-C) using a homogeneous assay). Results. At all postprandial times, levels of

LDL-C showed highly significant (pv0.005) decreases compared to time 0 (mean [95 % CI] maximum change in

LDL-C levels at 3.0 h: 20.16 mmol/L [20.12; 20.20]; pv0.001). Independently of fasting LDL-C levels and

ongoing statin therapy, LDL-C decreased significantly more in female compared to male patients postprandially

(mean [95 % CI] maximum unadjusted change versus time 0 in LDL-C for men [n556] at 3.0 h: 20.14 mmol/L

[20.19; 20.10], pv0.001; for women [n518] at 4.5 h: 20.26 mmol/L [20.35; 20.18], pv0.001; 20.14 mmol/L

[20.24; 20.05], p50.005 between genders for the mean [95 % CI] fasting adjusted difference at 4.5 h in the

change versus time 0 in LDL-C; gender by time interaction: p50.007 (repeated measures mixed model)).

Conclusions. In T2DM patients served a fat-rich meal, levels of LDL-C decreased significantly more in women

compared to men postprandially, irrespective of fasting levels or ongoing statin therapy. This might have

implications in the atherosclerotic process and on any difference in the risk of CVD between genders.

Keywords: Cholesterol; diabetes mellitus type-2; fasting; gender; hydroxymethylglutaryl-CoA reductase

inhibitors; lipoproteins; low density lipoprotein cholesterol (LDL-C); postprandial period; statins; ultracentrifugation

Original languageEnglish
JournalScandinavian Journal of Clinical & Laboratory Investigation
Issue number7
Pages (from-to)628-640
Number of pages13
Publication statusPublished - 2008

ID: 8697120