![]() ![]() triglycerides measured within 8 h of an unstandardised meal) are a strong predictor of CVD, and in some cases, more closely related to risk than fasting triglycerides ( 20– 22). >2⋅0 mmol/l or 177 mg/dl) with increased waist circumference also display elevated insulin, apolipoprotein (apo)B and small LDL-particles, fasting triglycerides are likely most useful in screening for more moderate stages of declining metabolic health ( 19).ĭespite triglycerides historically being measured in the fasted state, the rise in triglycerides following a meal, or postprandial lipaemia, has become increasingly examined due to epidemiological evidence that non-fasting triglycerides (i.e. Given that 84 % of those with fasting triglycerides marginally above the recommended cut-off (i.e. increased small, dense low-density lipoprotein (LDL), increased LDL triglycerides) ( 17, 18). In addition to their relationship with these metabolic changes, fasting triglycerides strongly correlate with other adverse, and more complex, lipid profile changes that are less easily measured (e.g. Chronically elevated fasting triglycerides in the absence of a genetic lipid disorder are associated with some degree of metabolic derangement, which can include long-term positive energy balance and adipose tissue expansion, hepatic steatosis and subsequent very-low-density lipoprotein (VLDL) oversecretion and/or insulin resistance ( 1, 7– 16). Triglycerides >1⋅70 mmol/l (150 mg/dl) are also one criterion for diagnosis of the metabolic syndrome and are frequently observed in those with type 2 diabetes ( 3– 6). High fasting triglycerides have been associated with cardiovascular disease (CVD) since the 1950s, and nearly one-third of Americans display elevated triglycerides (>1⋅70 mmol/l or 150 mg/dl) ( 1, 2). We also present data suggesting that there may be a distinct advantage of postprandial triglycerides, even over non-fasting triglycerides, for early detection of CVD risk and offer suggestions to make postprandial protocols more clinically feasible. Here, we review differences in assessment, the underlying physiology and the pathophysiological relevance of elevated fasting, non-fasting and postprandial triglycerides. A third type of triglyceride assessment, postprandial testing, is more controlled, yet historically has been difficult to implement due to the time and effort required to execute it. However, unstandardised assessment protocols associated with non-fasting triglyceride measurement may lead to misclassification, with at-risk individuals being overlooked. measured within 8 h of eating) better predict CVD than fasting triglycerides, which has led several organisations to recommend non-fasting lipid panels as the new clinical standard. Evidence suggests that non-fasting triglycerides (i.e. Fasting triacylglycerols have long been associated with cardiovascular disease (CVD) and other cardiometabolic conditions.
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