Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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Advances in Clinical and Experimental Medicine

2010, vol. 19, nr 1, January-February, p. 89–98

Publication type: original article

Language: English

Postprandial Lipemia and C-Reactive Protein in Middle-Aged Men Treated for Hyperlipemia

Lipemia poposiłkowa i białko C-reaktywne u mężczyzn w średnim wieku leczonych z powodu hiperlipemii

Anna Skoczyńska1,, Rafał Poręba1,, Bogusława Kreczyńska1,, Barbara Turczyn1,, Anna Wojakowska1,

1 Department of Internal and Occupational Diseases and Hypertension, Wroclaw Medical University, Poland

Abstract

Background. Postprandial lipoproteins enhance inflammatory activity, but the mechanisms of this action remain unclear.
Objectives. The aim of the study was to determine postprandial lipemia in hyperlipemic subjects and to study the relationship between lipids and high-sensitivity C-reactive protein (hs-CRP) in fasted and postprandial states.
Material and Methods. Blood samples were taken from 148 men (60 normolipemic, 27 hypertriglyceridemic, 49 hypercholesterolemic, and 12 with mixed hyperlipemia) in a fasted state and three hours after a standardized high-fat meal (1500 kcal) three times: before and after 6 and and 12-weeks of therapy with simvastatin (20 mg/ /day) and/or fenofibrate (267 mg/day). Triglycerides (TG), total lipoprotein, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and HDL2- and HDL3-cholesterol were measured by routine methods, apolipoproteins A and B by immunoturbidimetry, and hs-CRP by immunonephelometry.
Results. At the start of the study the mean hs-CRP level was increased (p < 0.05) in the hyperlipemic vs. the normolipemic men whereas the mean postprandial triglyceride increase (ΔTG) was higher (p < 0.05) in the men with hypertriglyceridemia. However, fasting TG (TGo) > 400 mg/dl was associated with low ΔTG and TGo < 400 mg/dl with high TG changes. Hypolipemic therapy caused a reduction in postprandial TG changes in all the hyperlipemic men. Linear correlation between the concentrations of TG and HDL as well as HDL3-cholesterol was found. Positive correlation between TGo and hs-CRP concentrations coexisted with a negative relationship between HDL3-cholesterol and hs-CRP only in the control group. Statin restored the relationship between the concentrations of HDL3-C and hs-CRP in the hypercholesterolemic men.
Conclusion. Increased postprandial lipemia in hyperlipemic men was associated with increased inflammatory activity and HDL3-cholesterol seems to have anti-inflammatory properties. Hypolipemic therapy decreased postprandial lipemia and at least partially recovered regulatory function in lipid homeostasis.

Streszczenie

Wprowadzenie. Lipemia poposiłkowa jest związana ze wzrostem aktywności zapalnej, chociaż mechanizm tego związku jest niejasny.
Cel pracy. Określenie lipemii poposiłkowej u osób z hiperlipemią i ocena zależności występujących między lipidami i wysoko czułym białkiem C-reaktywnym (hsCRP) w warunkach przed i po posiłku.
Materiał i metody. Badaniem objęto 148 mężczyzn (60 normolipemicznych, 27 z hipertrójglicerydemią, 49 z hipercholesterolemią i 12 z mieszaną hiperlipemią). Próbki krwi pobierano na czczo oraz po 3 godzinach od spożycia standaryzowanego posiłku wysokotłuszczowego (1500 kcal) 3-krotnie: przed, po 6 i po 12 tygodniach terapii simwastatyną (20 mg/dobę) i/lub fenofibratem (267 mg/dobę). Trójglicerydy (TG), cholesterol (całkowity, LDL, HDL, HDL2 i HDL3) oznaczano metodami rutynowymi, apolipoproteiny A and B immunoturbidymetrycznie, a hsCRP immunonefelometrycznie.
Wyniki. Na początku badania średnie stężenie hsCRP u mężczyzn z hiperlipemią było większe (p < 0,05) niż u mężczyzn z normolipemią, poposiłkowe zwiększenie stężenia trójglicerydów (ΔTG) natomiast był większe (p < 0,05) u mężczyzn z hipertriglyceridemią. Jednocześnie wartościom TG na czczo (TGo) > 400 mg/dL towapharrzyszyły mniejsze ΔTG, podczas gdy TGo < 400 mg/dL były związane z większymi poposiłkowymi zmianami TG. Leczenie hipolipemizujące istotnie ograniczało lipemię poposiłkową. Wykazano występowanie liniowych zależności między stężeniami TG a HDL lub HDL3-cholesterolu. Dodatnia korelacja między TGo i hsCRP współistniała z ujemną zależnością między HDL3-cholesterolem a hsCRP tylko w grupie kontrolnej. Statyna przywracała zależność między stężeniami HDL3-C a hsCRP u mężczyzn z hipercholesterolemią.
Wnioski. Zwiększona lipemia poposiłkowa u mężczyzn leczonych z powodu hiperlipemii jest związana ze zwiększoną aktywnością zapalną, a subfrakcja HDL3 wydaje się mieć właściwości przeciwzapalne. Leczenie hipolipemizujące zmniejsza lipemię poposiłkową i przynajmniej częściowo przywraca prawidłowe funkcje regulacyjne w homeostazie lipidów.

Key words

postprandial lipemia, C-reactive protein, statin, fibrate, hyperlipemia

Słowa kluczowe

lipemia poposiłkowa, białko C-reaktywne, statyna, fibrat, hiperlipemia

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