Postprandial lipemia in diabetic men during hypolipemic therapy

Introduction Mechanisms underlying postprandial lipemia in various pathological states remain to be elucidated. Objectives The aim of the study was to evaluate lipid homeostasis in men with type 2 diabetes mellitus (DM) after a standard meal. Moreover, the effect of short‑term hypolipemic therapy on postprandial lipemia was assessed. Patients and methods Twenty‑six men with DM aged 53 ±6.7 years, 27 patients with hyperlipemia and no DM (asymptomatic hyperlipemia – AH) and 60 normolipemic subjects aged 46 ±11 years were included in the study. Treatment with simvastatin (20 mg/d) or fenofibrate (267 mg/d) was initiated in all DM patients due to fasting hyperlipemia, and in the AH group. Blood samples were drawn in the fasting state and 3 h after a meal at three time points, i.e. at baseline, after 6 and 12 weeks of treatment. Triglycerides (TG), glucose, total cholesterol, low‑density lipoprotein cholesterol (LDL‑C), high‑density lipoprotein cholesterol (HDL‑C), HDL2‑C, and HDL3‑C were assayed by routine laboratory tests; apolipoproteins A and B by immunoturbidimetry, and high‑sensitivity C‑reactive protein (hsCRP) by immunonephelometry. Results In men with DM, changes in triglycerides induced by a meal (140 ±68.0 mg/dl) were higher compared to normolipemic men (62.1 ±52.5 mg/dl, p <0.001) or AH subjects (76.3 ±80 mg/dl, p <0.05). There were no linear correlations between the levels of TG (or HDL cholesterol) and HDL3‑C, or between TG and hsCRP in the DM group. Hypolipemic treatment decreased fasting lipid and hsCRP levels, significantly reduced postprandial lipemia (p <0.001) and restored some correlations between lipid variables observed in the control group, but not those with hsCRP. Conclusions Type 2 DM is associated with increased postprandial lipemia and abnormal lipid homeostasis. Lipid intolerance detected in a postprandial lipemia test may be an indication for hypolipemic therapy.