The atherogenic plasma remnant-like particle cholesterol concentration is increased in the fasting and postprandial state in active acromegalic patients

BACKGROUND Premature atherosclerosis is a clinical feature in untreated acromegaly. Increased postprandial lipoprotein remnant levels are associated with premature atherosclerosis. In most studies, remnants have been measured indirectly using retinyl esters (RE) as a chylomicron core label. Remnants can also be directly quantified by immunoseparation using monoclonal antibodies to apolipoprotein (apo) AI and apo B100 to remove nonremnant lipoproteins. Cholesterol is quantified in the remaining apo E‐rich remnant fraction (RLP‐C). OBJECTIVE The aim of the present study was to investigate the role of postprandial lipaemia in patients with acromegaly to further define abnormalities leading to increased susceptibility for atherosclerosis. PATIENTS In a case–control study, the plasma postprandial lipoprotein remnant fraction (RLP‐C and RE) were analysed in six patients with active acromegaly [two females, four males; aged 53 ± 9 years; body mass index (BMI), 29 ± 4 kg/m2] and in six normolipidaemic control subjects (matched for age, gender, BMI and apo E genotype). They underwent an oral vitamin A fat loading test. RESULTS Baseline plasma triglycerides (TG) were not significantly different in patients (1·75 ± 0·71 mm) and controls (1·15 ± 0·46 mm). Lipoprotein lipase activity was significantly lower in patients than in controls (108 ± 21 vs. 141 ± 19 U/l, respectively; P