No abstract

The benefit of cardiac rehabilitation, after an acute ischaemic heart event, in exercise capacity is significantly lower in Type 2 diabetic patients. The response to cardiac rehabilitation in those with diabetes appears to be influenced by blood glucose levels.

Plasma apolipoprotein A-IV (apoA-IV) levels are found elevated in hypertriglyceridemic patients. However, the relationship between plasma apoA-IV level and postprandial lipemia is not well known and remains to be elucidated. Thus, our objective was to study the relationship between plasma apoA-IV and postprandial TG after an oral fat load test (OFLT). Plasma apoA-IV was measured at fast and during an OFLT in 16 normotriglyceridemic, normoglucosetolerant android obese subjects (BMI ‫؍‬ 34.6 ؎ 2.9 kg/m 2 ) and 30 normal weight controls (BMI ‫؍‬ 22.2 ؎ 2.3 kg/m 2 ). In spite of not statistically different fasting plasma TG levels in controls and obese patients, the former group showed an altered TG response after OFLT, featuring increased nonchylomicron TG area under the curve (AUC) compared with controls (516 ؎ 138 vs. 426 ؎ 119 mmol/l ؒ min, P Ͻ 0.05). As compared to controls, obese patients showed increased apoA-IV levels both at fast (138.5 ؎ 22.4 vs. 124.0 ؎ 22.8 mg/l, P Ͻ 0.05) and during the OFLT (apoA-IV AUC: 79,833 ؎ 14,281 vs. 68,176 ؎ 17,463 mg/l ؒ min, P Ͻ 0.05). Among the whole population studied, as among the control and obese subgroups, fasting plasma apoA-IV correlated significantly with AUC of plasma TG ( r ‫؍‬ 0.60, P Ͻ 0.001), AUC of chymomicron TG ( r ‫؍‬ 0.45, P Ͻ 0.01), and AUC of nonchylomicron TG ( r ‫؍‬ 0.62, P Ͻ 0.001). In the multivariate analysis, fasting apoA-IV level constituted an independent and highly significant determinant of AUC of plasma TG, AUC of chymomicron TG, AUC of nonchylomicron TG, and incremental AUC of plasma TG. In conclusion, we show a strong link between fasting apoA-IV and postprandial TG metabolism. Plasma fasting apoA-IV is shown to be a good marker of TG response after an OFLT, providing additional information on post-load TG response in conjunction with other known factors such as fasting TGs. -Vergès,

NIDDM is associated with multiple apoB metabolism abnormalities that are potentially atherogenic. In addition to the increased number of circulating VLDL and IDL particles, the increased residence time observed on all apoB-containing lipoproteins may promote the development of atherosclerotic lesions, by potentiating their oxidizability.