Differences in postprandial lipemia in diabetic and non-diabetic subjects

Purpose: Postprandial lipemia is an independent risk factor for conorary heart disease in the general population. Our study investigates differences regarding postprandial lipidemic performance in diabetic and non-diabetic patients alter an oral fat load test. Methods: The study group consisted of 20 type 2 diabetic patients (Group A: 17 males and 3 females) and 12 non-diabetic subjects, as control group I(iroup B: 6 males and 6 fcmalesl. BMI, WHR and blood pressure was determined to all the participants. After an overnight fast. patients consumed a fatty meal of 677 Kcal/mconsisting of 82% fat, 3.2% protein and 14.8% carbohydrates, with 300.000 IU of vitamin A added. Blood samples for the determination of total cholesterol, triglycerides and HDL (enzymatic method) were drawn at baseline and 2, 4, 6 and 8 h after the fatty meal. The area under the incremental curve (AUIC) was calculated by plotting the concentration for each variable over the 8 h and integrating the area bet~een the curve and the fasting concentration from each postprandial ~alue. Patients with hepatic, thyroid and renal dysfunction and patients under hypolipidemic therapy were excluded from the study. Statistical analysis was performed using ANOVA. The level of significance was at p < 0.05. Results: The two groups were comparable according to age (54.55+6.13 yr. vs 52.26±4.58 yr., p: ns), BMI (27.445:1.98 vs 25.745:3.04, p: ns) and WHR (0.96±0.08 vs 0.925: 0.09, p: ns). Regarding lipidemic profile at baseline diabetic patients had lower plasma levels of HDL (44.75:10.603 vs 66.33±20.36. p = 0.00042). Regarding postprandial performance diabetic patients had significantly higher triglycerides (Trg) at 4.6 and 8 h (Trg 6 h: 234.45+89.72 vs 147.5±59.51, p = 0.00571, Trg 8 h: 191.755:87.66 vs 123.165:52.46. p = 0.0203k The AUIC for Trg at 6 to 8 h was significantly higher in group A ( 155± 124.2 mg*h/dl vs 67.66±83.97 mg*h/dl, p = 0.039). Regarding HDL diabetic patients had lower levels in almost all the postprandial phase (HDL 8 h: 42,055:11.7 vs 59.16±23.02. p = 0.008) and the total AUIC for HDL was in absolute values significantly higher in non-diabetic patients (AUIC HDL: -7.855:55.04 mg*h/dl vs -67+88.07 mg*h/dl, p = 0.025). We did not observe any statistically significant differences regarding the postprandial performance of total cholesterol and LDL between the two groups. Conclusion: In the postprandial phase diabetic patients show prolonged hypertriglyceridaemia, with a comparative peak in relation to non-diabetics at 6 to 8 h. HDL-cholesterol remains significantly lower in diabetic patients but with a lower reduction tendency compared to non-diabetic patients. No significant differences are observed regarding total and LDL cholesterol between the two groups. LIPID LEVELS, BLOOD RHEOLOGY AND MICROCIRCULATION IN PATIENTS WITH CHRONIC RENAL FAILURE