Introduction: Postprandial lipemia characterized by a rise in triglyceride-rich lipoproteins after eating, is associated with increased risk of cardiovascular disease. Among diabetic patients, postprandial lipemia is often overlooked once fasting lipid parameters are within target. The aim of the study is to determine the correlation of glycemic control and postprandial hyperglycemia with postprandial lipemia among patients wi th type 2 diabetes mellitus (DM). The result of the study may have important implications on how dyslipidemia should be completely addressed.

Methodology: A clinic-based retrospective chart review of 102 patients with recorded fasting and postprandial blood measurements was performed. Subjects included adult patients with type 2 DM whose fasting lipid parameters were controlled with diet and/or medications. Plasma glucose and glycosylated hemoglobin (HbA1C) were independent variables while triglyceride, total cholesterol, low density lipoprotein (LDL) and high density lipoprotein (HDL) were dependent variables. Pearson correlation was used to determine the strength of relationships among the variables mentioned. A p-value <0.05 was considered significant.

Results: Of the 102 patients, 52.9% and 47.1% were achieving their target HbA1C and two-hour postprandial plasma glucose, respectively. The postprandial level of plasma glucose, mean triglyceride, total cholesterol, LDL and HDL were 196.39 mg/dL, 189.06 mg/dL, 177.07 mg/dL, 122.40 mg/dL and 34.83 mg/dL, respectively. HbA1C has strong positive correlation with postprandial lipemia (Pearson’s r=0.40) while the two-hour plasma glucose has moderate positive correlation (Pearson’s r=0.34) with postprandial lipemia. Both relationships were considered significant (p-value <0.05).

Conclusion: A significant correlation of glycemic control and postprandial hyperglycemia with postprandial lipemia was observed. Our data suggest that despite achievement of optimal fasting lipid parameters, poor control of diabetes is positively correlated with abnormal elevation of postprandial triglyceride. Addressing both postprandial hyperglycemia and lipemia may improve cardiovascular outcome.

Keywords: postprandial lipemia, postprandial hyperglycemia, diabetes mellitus

1. Iovine C, Vacarro O, Gentile A, Romano G, Pisanti F, Riccardi G, Rivellese A. Postprandial triglyceride profile in a population-based sample of type 2 diabetic patients. Diabetologia (2004) 47:19-22
2. O’Keefe J, Bell D. Postprandial Hyperglycemia/Hyperlipidemia (Postprandial Dysmetabolism) is a Cardiovascular Risk Factor. The American Journal of Cardiology (2007) 100:899-904
3. Mero N, Syvanne M, Taskinen M. Postprandial lipid metabolism in diabetes. Atherosclerosis. (1998) 141:53-55
4. Klop B, Proctor S, Mamo J, Botham K, Cabezas M. Understanding postprandial inflammation and its relationship to lifestyle behavior and metabolic diseases. Int J Vasc Med (2011) 2012
5. Goldberg I. Diabetic Dyslipidemia: Causes and Consequences (2001). The Journal of Clinical Endocrinology and Metabolism 86(3):965-970
6. Teno S, Uto Y, Nagashima H, Endoh Y, Iwamoto Y, Omori Y, Takizawa T. Association of Postprandial Hypertriglyceridemia and Carotid Intima-Media Thickness in Patients with Type 2 Diabetes. Diabetes Care (2000) 23(9): 1401-06
7. Bansal S, Buring J, Rifai N, Mora S, Sacks F. Fasting Compared with Non-fasting Triglycerides and Risk of Cardiovascular Events in Women. JAMA (2007) 289(3):309-316
8. Marchesi, S, Lupatelli, G, Schillaci, G, Impaired Flow-Mediated Vasoactivity During Post-prandial Phase in Young Healthy Men. Atherosclerosis (2000) 153: 397-402
9. National Cholesterol Education Program (NCEP) Expert Panel Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. J Am Med Assoc (1993) 269:3015-3023
10. Taylor R. Interpretation of the Correlation Coefficient: A Basic Review. JDMS (1990) 1:35-39
11. Ramachandran A, Riddle M, Kabali C, Gerstein H. Relationship Between A1C and Fasting Plasma Glucose in Dysglycemia or Type 2 Diabetes. Diabetes Care (2012) 35:749-753
12. Bittner V, Johnson BD, Zineh I, Rogers W, Vido, D, Marroquin O, Bairey-Merz N and Sopko G. The TG/HDL Cholesterol Ratio Predicts All Cause Mortality in Women with Suspected Myocardial Ischemia A Report from Women’s Ischemia Syndrome. Am Heart J (2009) 157(3):548-555
13. Nordestgaard BG, Benn M, Schnohr P, Tybjaerg-Hansen A. Nonfasting triglycerides and risk of myocardial infarction, ischemic heart disease, and death in men and women. JAMA (2007) 298:299–308