Metabolic phenotypes of obesity influence triglyceride and inflammation homoeostasis

Background We examined the degree of postprandial triglyceride (TG) response over the day, representing a highly dynamic state, with continuous metabolic adaptations, among normal‐weight, overweight and obese patients, according to their metabolically healthy or abnormal status. Materials and methods A total of 1002 patients from the CORDIOPREV clinical trial (NCT00924937) were submitted to an oral fat load test meal with 0·7 g fat/kg body weight (12% saturated fatty acids (SFA), 10% polyunsaturated fatty acids (PUFA), 43% monounsaturated fatty acids (MUFA), 10% protein and 25% carbohydrates). Serial blood test analysing lipid fractions and inflammation markers (high‐sensitivity C‐reactive protein (hs‐CRP)) were drawn at 0, 1, 2, 3 and 4 h during postprandial state. We explored the dynamic response according to six body size phenotypes: (i) normal weight, metabolically healthy; (ii) normal weight, metabolically abnormal; (iii) overweight, metabolically healthy; (iv) overweight, metabolically abnormal; (v) obese, metabolically healthy; and (vi) obese, metabolically abnormal. Results Metabolically healthy patients displayed lower postprandial response of plasma TG and large triacylglycerol‐rich lipoproteins (TRLs)‐TG, compared with those metabolically abnormal, independently whether or not they were obese (P