Change in Postprandial Level of Remnant Cholesterol After a Daily Breakfast in Chinese Patients With Hypertension

Abstract

Background: Hypertension (HBP) is usually accompanied by hypertriglyceridemia that represents the increased triglyceride-rich lipoproteins and cholesterol content in remnant lipoproteins [i.e., remnant cholesterol (RC)]. According to the European Atherosclerosis Society (EAS), high RC (HRC) is defined as fasting RC ≥0.8 mmol/L and/or postprandial RC ≥0.9 mmol/L. However, little is known about postprandial change in RC level after a daily meal in Chinese patients with HBP.Methods: One hundred thirty-five subjects, including 90 hypertensive patients (HBP group) and 45 non-HBP controls (CON group), were recruited in this study. Serum levels of blood lipids, including calculated RC, were explored at 0, 2, and 4 h after a daily breakfast. Receiver operating characteristic (ROC) curve analysis was used to determine the cutoff point of postprandial HRC.Results: Fasting TG and RC levels were significantly higher in the HBP group (P < 0.05), both of which increased significantly after a daily meal in the two groups (P < 0.05). Moreover, postprandial RC level was significantly higher in the HBP group (P < 0.05). ROC curve analysis showed that the optimal cutoff point for RC after a daily meal to predict HRC corresponding to fasting RC of 0.8 mmol/L was 0.91 mmol/L, which was very close to that recommended by the EAS, i.e., 0.9 mmol/L. Fasting HRC was found in 31.1% of hypertensive patients but not in the controls. According to the postprandial cutoff point, postprandial HRC was found in approximately half of hypertensive patients and ~1-third of the controls.Conclusion: Postprandial RC level increased significantly after a daily meal, and hypertensive patients had higher percentage of HRC at both fasting and postprandial states. More importantly, the detection of postprandial lipids could be helpful to find HRC.

High Remnant Cholesterol Level Potentiates the Development of Hypertension

“…RC had higher penetration into the arterial wall than traditional lipids and elicited arterial wall inflammation as well as low-grade systemic inflammation, further supporting the contribution of RC to vascular damage and atherosclerosis (14,15). There were preliminary studies based on the small number of individuals that showed high RC (HRC) was associated with higher central systolic blood pressure and the incidence of hypertension (16)(17)(18). However, the abovementioned studies focused on a singledirection relationship between RC and hypertension, but the temporal relationship between these two entities has not been elucidated.…”

Comparison between Fasting and Non-Fasting Cut-Off Values of Triglyceride in Diagnosing High Triglyceride in Chinese Hypertensive Outpatients

“…According to the fasting cut-off value commonly used in the management of marked HTG in the Chinese population, the percentage of marked HTG in the fasting group was 34.5%. According to the non-fasting cut-off values to determine HTG, HRC, and marked HTG reported in Chinese subjects [ 15 , 16 , 17 ], the percentages of HTG, HRC, and marked HTG in the non-fasting group were 72.6%, 70.8%, and 57.5%, respectively ( Figure 2 A–C).…”

“…According to the European joint consensus statement from the EAS [ 16 ], the fasting cut-off values to determine HTG and HRC are TG levels of 1.7 mmol/L and RC levels of 0.8 mmol/L, respectively. Their corresponding non-fasting cut-off values to determine HTG and HRC are TG level 2.0 mmol/L and RC level 0.9 mmol/L [ 5 , 17 ], respectively.…”

Non-fasting Changes in Blood Lipids After Three Daily Meals Within a Day in Chinese Inpatients With Cardiovascular Diseases

“…Meals were purchased from the hospital canteen. We previously found that the levels of TG, LDL-C, and RC changed most prominently at 4 h than at 2 h after a daily meal ( 17 – 19 ). Thus, venous blood samples were collected before breakfast and at 4 h after each meal.…”

“…Elevated non-fasting TG and RC levels were regarded as pathogenic risk factors for myocardial infarction ( 16 ). We previously found that TG and RC levels increased while LDL-C level decreased most prominently at 4 h after a daily breakfast in Chinese subjects, which includes those with CHD, overweight, and hypertension ( 17 – 19 ). Although the non-fasting changes in blood lipids were considered insignificant in Danish studies with large population ( 14 ), reduction in LDL-C level after a breakfast was found more obvious in several previous studies with Chinese subjects ( 17 – 19 ).…”