Who would benefit most from postprandial lipid screening?
Individuals with fasting triglycerides (TG) 1.50 mmol/L) exhibited PPTG ≥220 mg/dL (≥2.50 mmol/L), while 100% of individuals with fasting TG
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| Veröffentlicht in: | Clinical nutrition (Edinburgh, Scotland) Scotland), 2021-07, Vol.40 (7), p.4762-4771 |
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| container_title | Clinical nutrition (Edinburgh, Scotland) |
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| creator | Sciarrillo, Christina M. Koemel, Nicholas A. Keirns, Bryant H. Banks, Nile F. Rogers, Emily M. Rosenkranz, Sara K. Kurti, Stephanie P. Jenkins, Nathaniel D.M. Emerson, Sam R. |
| description | Individuals with fasting triglycerides (TG) 1.50 mmol/L) exhibited PPTG ≥220 mg/dL (≥2.50 mmol/L), while 100% of individuals with fasting TG |
| doi_str_mv | 10.1016/j.clnu.2021.04.022 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2550260359</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0261561421002144</els_id><sourcerecordid>2550260359</sourcerecordid><originalsourceid>FETCH-LOGICAL-c400t-dd8bab7ab9f13bb8c32b78d09334d4948c89325d53c0dc0bea40b0a8c12aca03</originalsourceid><addsrcrecordid>eNp9kEtLw0AUhQdRbK3-AReSpZvEO680A4JI8QUFNwWXw7yiU5JMnEkU_70pVZeu7l1858D5EDrHUGDA5dW2ME03FgQILoAVQMgBmmNOSY5FRQ_RHEiJc15iNkMnKW0BgNNldYxmlBFGBC7nSLy8hewzjI3NtOtc7YesDWnI6hjarJ--PqrOetVkje-9zZKJznW-e705RUe1apI7-7kLtLm_26we8_Xzw9Pqdp0bBjDk1lZa6aXSosZU68pQopeVBUEps0ywylSCEm45NWANaKcYaFCVwUQZBXSBLve1fQzvo0uDbH0yrmlU58KYJOF8mgmUiwkle9TEkFJ0teyjb1X8khjkzpjcyp0xuTMmgcnJ2BS6-OkfdevsX-RX0QRc7wE3jfzwLspkvOuMsz46M0gb_H_9307hfKQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2550260359</pqid></control><display><type>article</type><title>Who would benefit most from postprandial lipid screening?</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Sciarrillo, Christina M. ; Koemel, Nicholas A. ; Keirns, Bryant H. ; Banks, Nile F. ; Rogers, Emily M. ; Rosenkranz, Sara K. ; Kurti, Stephanie P. ; Jenkins, Nathaniel D.M. ; Emerson, Sam R.</creator><creatorcontrib>Sciarrillo, Christina M. ; Koemel, Nicholas A. ; Keirns, Bryant H. ; Banks, Nile F. ; Rogers, Emily M. ; Rosenkranz, Sara K. ; Kurti, Stephanie P. ; Jenkins, Nathaniel D.M. ; Emerson, Sam R.</creatorcontrib><description>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.
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%.
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.
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.
•Postprandial TG are a more sensitive indicator of CVD risk when compared to fasting TG.•Simplifying criteria regarding postprandial TG testing will lead to better detection of CVD risk.•Individuals with fasting TG of 70–130 mg/dL should be recommended for postprandial TG testing.</description><identifier>ISSN: 0261-5614</identifier><identifier>ISSN: 1532-1983</identifier><identifier>EISSN: 1532-1983</identifier><identifier>DOI: 10.1016/j.clnu.2021.04.022</identifier><identifier>PMID: 34242916</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adolescent ; Adult ; Aged ; Atherosclerosis ; Cardiovascular disease ; Fasting - blood ; Female ; Healthy Volunteers ; Heart Disease Risk Factors ; Humans ; Hypertriglyceridemia - diagnosis ; Male ; Middle Aged ; Postprandial Period ; Predictive Value of Tests ; Risk assessment ; Risk Assessment - methods ; Sensitivity and Specificity ; Triglycerides ; Triglycerides - blood ; Young Adult</subject><ispartof>Clinical nutrition (Edinburgh, Scotland), 2021-07, Vol.40 (7), p.4762-4771</ispartof><rights>2021 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism</rights><rights>Copyright © 2021 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-dd8bab7ab9f13bb8c32b78d09334d4948c89325d53c0dc0bea40b0a8c12aca03</citedby><cites>FETCH-LOGICAL-c400t-dd8bab7ab9f13bb8c32b78d09334d4948c89325d53c0dc0bea40b0a8c12aca03</cites><orcidid>0000-0002-2354-1534 ; 0000-0003-1781-3414 ; 0000-0001-5837-4820 ; 0000-0002-3297-1640 ; 0000-0003-4803-9054</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.clnu.2021.04.022$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,45974</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34242916$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sciarrillo, Christina M.</creatorcontrib><creatorcontrib>Koemel, Nicholas A.</creatorcontrib><creatorcontrib>Keirns, Bryant H.</creatorcontrib><creatorcontrib>Banks, Nile F.</creatorcontrib><creatorcontrib>Rogers, Emily M.</creatorcontrib><creatorcontrib>Rosenkranz, Sara K.</creatorcontrib><creatorcontrib>Kurti, Stephanie P.</creatorcontrib><creatorcontrib>Jenkins, Nathaniel D.M.</creatorcontrib><creatorcontrib>Emerson, Sam R.</creatorcontrib><title>Who would benefit most from postprandial lipid screening?</title><title>Clinical nutrition (Edinburgh, Scotland)</title><addtitle>Clin Nutr</addtitle><description>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.
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%.
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.
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.
•Postprandial TG are a more sensitive indicator of CVD risk when compared to fasting TG.•Simplifying criteria regarding postprandial TG testing will lead to better detection of CVD risk.•Individuals with fasting TG of 70–130 mg/dL should be recommended for postprandial TG testing.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Atherosclerosis</subject><subject>Cardiovascular disease</subject><subject>Fasting - blood</subject><subject>Female</subject><subject>Healthy Volunteers</subject><subject>Heart Disease Risk Factors</subject><subject>Humans</subject><subject>Hypertriglyceridemia - diagnosis</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Postprandial Period</subject><subject>Predictive Value of Tests</subject><subject>Risk assessment</subject><subject>Risk Assessment - methods</subject><subject>Sensitivity and Specificity</subject><subject>Triglycerides</subject><subject>Triglycerides - blood</subject><subject>Young Adult</subject><issn>0261-5614</issn><issn>1532-1983</issn><issn>1532-1983</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEtLw0AUhQdRbK3-AReSpZvEO680A4JI8QUFNwWXw7yiU5JMnEkU_70pVZeu7l1858D5EDrHUGDA5dW2ME03FgQILoAVQMgBmmNOSY5FRQ_RHEiJc15iNkMnKW0BgNNldYxmlBFGBC7nSLy8hewzjI3NtOtc7YesDWnI6hjarJ--PqrOetVkje-9zZKJznW-e705RUe1apI7-7kLtLm_26we8_Xzw9Pqdp0bBjDk1lZa6aXSosZU68pQopeVBUEps0ywylSCEm45NWANaKcYaFCVwUQZBXSBLve1fQzvo0uDbH0yrmlU58KYJOF8mgmUiwkle9TEkFJ0teyjb1X8khjkzpjcyp0xuTMmgcnJ2BS6-OkfdevsX-RX0QRc7wE3jfzwLspkvOuMsz46M0gb_H_9307hfKQ</recordid><startdate>202107</startdate><enddate>202107</enddate><creator>Sciarrillo, Christina M.</creator><creator>Koemel, Nicholas A.</creator><creator>Keirns, Bryant H.</creator><creator>Banks, Nile F.</creator><creator>Rogers, Emily M.</creator><creator>Rosenkranz, Sara K.</creator><creator>Kurti, Stephanie P.</creator><creator>Jenkins, Nathaniel D.M.</creator><creator>Emerson, Sam R.</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2354-1534</orcidid><orcidid>https://orcid.org/0000-0003-1781-3414</orcidid><orcidid>https://orcid.org/0000-0001-5837-4820</orcidid><orcidid>https://orcid.org/0000-0002-3297-1640</orcidid><orcidid>https://orcid.org/0000-0003-4803-9054</orcidid></search><sort><creationdate>202107</creationdate><title>Who would benefit most from postprandial lipid screening?</title><author>Sciarrillo, Christina M. ; Koemel, Nicholas A. ; Keirns, Bryant H. ; Banks, Nile F. ; Rogers, Emily M. ; Rosenkranz, Sara K. ; Kurti, Stephanie P. ; Jenkins, Nathaniel D.M. ; Emerson, Sam R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c400t-dd8bab7ab9f13bb8c32b78d09334d4948c89325d53c0dc0bea40b0a8c12aca03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Atherosclerosis</topic><topic>Cardiovascular disease</topic><topic>Fasting - blood</topic><topic>Female</topic><topic>Healthy Volunteers</topic><topic>Heart Disease Risk Factors</topic><topic>Humans</topic><topic>Hypertriglyceridemia - diagnosis</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Postprandial Period</topic><topic>Predictive Value of Tests</topic><topic>Risk assessment</topic><topic>Risk Assessment - methods</topic><topic>Sensitivity and Specificity</topic><topic>Triglycerides</topic><topic>Triglycerides - blood</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sciarrillo, Christina M.</creatorcontrib><creatorcontrib>Koemel, Nicholas A.</creatorcontrib><creatorcontrib>Keirns, Bryant H.</creatorcontrib><creatorcontrib>Banks, Nile F.</creatorcontrib><creatorcontrib>Rogers, Emily M.</creatorcontrib><creatorcontrib>Rosenkranz, Sara K.</creatorcontrib><creatorcontrib>Kurti, Stephanie P.</creatorcontrib><creatorcontrib>Jenkins, Nathaniel D.M.</creatorcontrib><creatorcontrib>Emerson, Sam R.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical nutrition (Edinburgh, Scotland)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sciarrillo, Christina M.</au><au>Koemel, Nicholas A.</au><au>Keirns, Bryant H.</au><au>Banks, Nile F.</au><au>Rogers, Emily M.</au><au>Rosenkranz, Sara K.</au><au>Kurti, Stephanie P.</au><au>Jenkins, Nathaniel D.M.</au><au>Emerson, Sam R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Who would benefit most from postprandial lipid screening?</atitle><jtitle>Clinical nutrition (Edinburgh, Scotland)</jtitle><addtitle>Clin Nutr</addtitle><date>2021-07</date><risdate>2021</risdate><volume>40</volume><issue>7</issue><spage>4762</spage><epage>4771</epage><pages>4762-4771</pages><issn>0261-5614</issn><issn>1532-1983</issn><eissn>1532-1983</eissn><abstract>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.
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%.
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.
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.
•Postprandial TG are a more sensitive indicator of CVD risk when compared to fasting TG.•Simplifying criteria regarding postprandial TG testing will lead to better detection of CVD risk.•Individuals with fasting TG of 70–130 mg/dL should be recommended for postprandial TG testing.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>34242916</pmid><doi>10.1016/j.clnu.2021.04.022</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-2354-1534</orcidid><orcidid>https://orcid.org/0000-0003-1781-3414</orcidid><orcidid>https://orcid.org/0000-0001-5837-4820</orcidid><orcidid>https://orcid.org/0000-0002-3297-1640</orcidid><orcidid>https://orcid.org/0000-0003-4803-9054</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Adolescent Adult Aged Atherosclerosis Cardiovascular disease Fasting - blood Female Healthy Volunteers Heart Disease Risk Factors Humans Hypertriglyceridemia - diagnosis Male Middle Aged Postprandial Period Predictive Value of Tests Risk assessment Risk Assessment - methods Sensitivity and Specificity Triglycerides Triglycerides - blood Young Adult |
| title | Who would benefit most from postprandial lipid screening? |
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