Lifestyle factors modulate postprandial hypertriglyceridemia: from the CORDIOPREV study

Authors: LEON-ACUNA, ANA - Universidad De Cordoba; TORRES-PENA, JOSE - Universidad De Cordoba; ALCALA-DIAZ, JUAN - Universidad De Cordoba; VALS-DELGADO, CRISTINA - Universidad De Cordoba; RONCERO-RAMOS, IRENE - Universidad De Cordoba; YUBERO-SERRANO, ELENA - Universidad De Cordoba; TINAHONES, FRANCISCO - Instituto De Salud Carlos Iii; CASTRO CLERICO, MANUEL - Reina Sofia University; DELGADO-LISTA, JAVIER - Universidad De Cordoba; ORDOVAS, JOSE - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; LOPEZ-MIRANDA, JOSE - Universidad De Cordoba; PEREZ-MARTINEZ, PABLO - Universidad De Cordoba

Submitted to: Atherosclerosis
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 9/27/2019
Publication Date: 9/28/2019
Citation: Leon-Acuna, A., Torres-Pena, J.D., Alcala-Diaz, J.F., Vals-Delgado, C., Roncero-Ramos, I., Yubero-Serrano, E., Tinahones, F.J., Castro Clerico, M., Delgado-Lista, J., Ordovas, J.M., Lopez-Miranda, J., Perez-Martinez, P. 2019. Lifestyle factors modulate postprandial hypertriglyceridemia: from the CORDIOPREV study. Atherosclerosis. 290:118-124. https://doi.org/10.1016/j.atherosclerosis.2019.09.025.
DOI: https://doi.org/10.1016/j.atherosclerosis.2019.09.025

Interpretive Summary: Cardiovascular risk biomarkers have been traditionally measured in the fasting state; however, more recent evidence suggests that postprandial hypertriglyceridemia (PPT) may be a better risk marker. Genetics, age, gender as well as physical activity, smoking and regular alcohol have shown their ability to modulate PPT. In order to verify such effects, we evaluated the influence of regular alcohol intake, physical activity and smoking habit on the modulation of PPT in the CORDIOPREV study. For this purpose, 1002 patients were subject to an oral fat load test meal and serial blood samples were drawn at 0, 1, 2, 3 and 4 h during postprandial state. The prevalence of elevated PPT response was higher in current and recent ex-smokers, than in long-term ex-smokers and never smokers. No differences were observed in the magnitude of PPT according to regular physical activity or alcohol intake habits. In conclusion, smoking is an independent risk factor modulating the magnitude of PPT. However, after tobacco cessation, ex-smokers show a progressive decrease on their PPT to reach levels similar to those of never smokers.

Technical Abstract: BACKGROUND AND AIMS: Recent evidence suggests that post-meal hypertriglyceridemia (PMT) is associated with the incidence of CVD. Several non-modifiable factors (genetics, age, gender) and lifestyle factors (physical activity, smoking, regular alcohol) have shown their ability to modulate PMT. We evaluate the influence of regular alcohol intake, physical activity and smoking habit modulating PMT in the CORDIOPREV study (NCT00924937). METHODS: 1002 patients were subject to an oral fat load test meal and serial blood samples were drawn at 0, 1, 2, 3 and 4 h during post-meal state. A PMT concentration above 2.5 mmol/L (220 mg/dL) at any time point has been established as a detrimental response. Alcohol consumption was defined as non-drinkers, moderate and severe intake; regular physical activity exceeding than or lower than 1000 MET/week; smoking habit was classified in current, never, recent ex-smokers and long-term ex-smokers. RESULTS: The prevalence of undesirable PMT response was 68% in current, 58% in recent ex-smokers, 49% in long-term ex-smokers and 48% in never smokers (p < 0.001). Current and recent ex-smokers displayed higher PMT response as well as a greater area under the curve (AUC) and higher incremental (iAUC) of triglycerides (TG) compared with long-term ex-smokers and never smokers (p < 0.05), without differences among these subgroups. No differences were observed in the magnitude of PMT according to regular physical activity or alcohol intake habits.