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    Who would benefit most from postprandial lipid screening?


    Sciarrillo, Christina M., Koemel, Nicholas A., Keirns, Bryant H., Banks, Nile, Rogers, Emily M., Rosenkranz, Sara K., Kurti, Stephanie P., Jenkins, Nathaniel D.M. and Emerson, Sam R. (2021) Who would benefit most from postprandial lipid screening? Clinical Nutrition, 40 (7). pp. 4762-4771. ISSN 02615614

    Abstract

    Background & aims Individuals with fasting triglycerides (TG) <150 mg/dL can experience a deleterious postprandial TG response ≥220 mg/dL to a high-fat meal (HFM). The purpose of this study was to identify individuals based on fasting TG that would benefit most from additional postprandial screening. Methods We conducted a secondary analysis of 7 studies from our laboratories featuring 156 disease-free participants (64 M, 92 F; age 18–70 years; BMI 18.5–30 kg/m2). Participants observed a 10–12 h overnight fast, after which they consumed an HFM (10–13 kcal/kg body mass; 61–64% kcal from fat). Two methods were used to identify lower and upper fasting TG cut points. Method 1 identified the lower limit as the TG concentration at which ≥90% of individuals presented peak postprandial TG (PPTG) <220 mg/dL and the upper limit as the concentration which ≥90% of individuals presented PPTG ≥220 mg/dL. Method 2 utilized receiver operating characteristic (ROC) curves and identified the lower limit as the fasting TG concentration where sensitivity was ≈95% and the upper limit as the concentration at which specificity was ≈95%. Results In Method 1, 90% of individuals with fasting TG >130 mg/dL (>1.50 mmol/L) exhibited PPTG ≥220 mg/dL (≥2.50 mmol/L), while 100% of individuals with fasting TG <66 mg/dL (0.75 mmol/L) had PPTG that did not exceed 220 mg/dL (2.50 mmol/L). In Method 2, when sensitivity was ≈95%, the corresponding fasting TG concentration was 70 mg/dL (0.79 mmol/L). When specificity was ≈95%, the corresponding fasting TG concentration was 114 mg/dL (1.29 mmol/L). Based on methods 1 and 2, there was a moderate positive association (r = 0.37, p < 0.004) between fasting and PPTG for individuals with fasting TG between 70 and 130 mg/dL (0.79–1.50 mmol/L), in which 24% exhibited PPTG ≥220 mg/dL (≥2.50 mmol/L) while 76% did not. Conclusions Postprandial TG testing is likely most useful for individuals with fasting TG concentrations between 70 and 130 mg/dL (0.79–1.50 mmol/L). Outside of this range, postprandial TG responses are largely predictable. Establishing a specific patient group for which postprandial TG testing is most useful may lead to earlier risk detection in these individuals.
    Item Type: Article
    Keywords: Cardiovascular disease; Triglycerides; Postprandial period; Atherosclerosis; Risk assessment;
    Academic Unit: Faculty of Science and Engineering > Sports Science and Nutrition
    Item ID: 20771
    Identification Number: 10.1016/j.clnu.2021.04.022
    Depositing User: Nile Banks
    Date Deposited: 29 Oct 2025 16:18
    Journal or Publication Title: Clinical Nutrition
    Publisher: Elsevier
    Refereed: Yes
    Related URLs:
    Use Licence: This item is available under a Creative Commons Attribution Non Commercial Share Alike Licence (CC BY-NC-SA). Details of this licence are available here

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