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(TRLs) and their cholesterol content(i.e. remnant cholesterol, RC). According to the European Atherosclerosis Society(EAS), high RC(HRC) is defined as fasting RC ≥ 0.8mmol/L or/and postprandial RC ≥ 0.9mmol/L. However, little was known about postprandial change in RC level after a daily meal in Chinese patients with HBP. Methods: One hundred and 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 cut-off point of postprandial HRC.Results: TG and RC levels increased significantly after a daily meal in two groups(P<0.05). However, postprandial RC level was significantly higher in HBP group( P<0.05). ROC curve analysis showed that the optimal cut-off point for RC after a daily meal to predict HRC in corresponding to fasting RC 0.8 mmol/L was 0.91 mmol/L, which was very close to that recommended by the EAS, i.e. 0.9mmol/L. Fasting HRC was found in 31.1% hypertensive patients but not in the controls. According to the postprandial cut-off point, postprandial HRC was found in about half of hypertensive patients and about one third of controls. Conclusion: Postprandial RC level increased significantly after a daily meal and hypertensive patients had higher percentage of HRC. More importantly, the detection of postprandial lipids is helpful to find HRC.

Hypertension, remnant cholesterol and cardiovascular disease: evidence from the China health and retirement longitudinal study

“…Several previous studies have reported a high level of plasma RC in normotensive subjects may predispose to the development of hypertension [27]. In turn, hypertensive patients had higher level of RC than those without hypertension [13]. Considering the closely relationship between hypertension, RC and CVD, our study focused on the combined effect of hypertension and RC.…”

“…Despite lipoprotein(a) and low-density lipoprotein cholesterol (LDL-C) [7,8], remnant cholesterol (RC) has been shown to play an important role in the incidence of atherosclerotic CVD [9][10][11]. In recent years, several studies have found a significant association between hypertension and RC: increased RC was significantly associated with higher central systolic blood pressure and hypertensive patients had higher level of RC [12,13]. However, no previous study has specifically evaluated the cumulative effect of hypertension and RC on risk of CVD in the general population.…”

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

“…In addition to the small sample size, another cause for this phenomenon could be the difference in the time of blood lipid test. We previously found that levels of TG and RC began to rise at 2 h and peaked at 4 h after a daily meal in Chinese in patients with coronary heart disease and HBP [13,14]. For some patients who are used to a high-fat and high-calorie diet, the peak of TG level may be higher or later [24,25].…”

“…Recently, we reported that the non-fasting cut-off values to determine HTG and HRC were TG level 2.02 mmol/L [13] and RC level 0.87 mmol/L [14], respectively, in Chinese subjects.…”

“…According to the cut-off values of HTG and HRC recommended by the EAS [12], the percentages of HTG and HRC in the fasting group were 57.1% and 52.9%, respectively, while those in the non-fasting group were 67.6% and 65.6%, respectively. According to the non-fasting cut-off values to determine HTG and HRC reported in Chinese subjects [13,14], the percentages of HTG and HRC in the non-fasting group were 67.6% and 67.6%, respectively (Fig. 2A-B).…”