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Nutrition and Disease

Fasting and Postprandial Remnant-Like Particle Cholesterol Concentrations in Obese Participants Are Associated with Plasma Triglycerides, Insulin Resistance, and Body Fat Distribution^1,2

³ Department of Human Biology, School for Nutrition, Toxicology and Metabolism, Maastricht University, 6229 ER Maastricht, The Netherlands; ⁴ Laboratory of Experimental Vascular Medicine, Academic Medical Center, 1105 AZ Amsterdam, The Netherlands; ⁵ Department of Physiology and Nutrition, University of Navarra, 31008 Pamplona, Spain; ⁶ Department of Nutrition, Hôtel-Dieu Hospital, University Pierre-et-Marie Curie (Paris 6), 75004 Paris, France; ⁷ Department of Sports Medicine, Centre of Preventive Medicine, Third Faculty of Medicine, Charles University, 10000 Prague, Czech Republic; ⁸ Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen, 1958 Frederiksberg, Denmark; ⁹ Department of Medicine, Karolinska Institute, Huddinge University Hospital, 14186 Stockholm, Sweden; ¹⁰ Institute of Preventive Medicine, Copenhagen University Hospital, Centre for Health and Society, 1357 Copenhagen, Denmark

Elevated plasma concentrations of remnant-like particle cholesterol (RLP-C) are atherogenic. However, factors that determine RLP-C are not fully understood. This study evaluates which factors affect RLP-C in the fasting and postprandial state, using multiple regression analyses in a large cohort of lean and obese participants. All participants (n = 740) underwent a test meal challenge containing 95 energy % (en%) fat (energy content 50% of predicted daily resting metabolic rate). Fasting and postprandial concentrations of circulating metabolites were measured over a 3-h period. Obese participants (n = 613) also participated in a 10-wk weight loss program (–2510 kJ/d), being randomized to either a low-fat or a high-fat diet (20–25 vs. 40–45en% fat). Postprandial RLP-C was associated with fasting RLP-C, waist:hip ratio (WHR), HOMA_IR (homeostasis model assessment index for insulin resistance) (P < 0.001), and age, independently of BMI and gender [adjusted R² (adj. R²) = 0.70). These factors were also related to fasting RLP-C (P < 0.010), along with gender and physical activity (adj. R² = 0.23). The dietary intervention resulted in significantly lower fasting RLP-C concentrations, independently mediated by weight loss, improvements in HOMA_IR, and the fat content of the prescribed diet. However, after inclusion of plasma triglyceride (TG), HDL-cholesterol, and FFA concentrations in the models, HOMA_IR and WHR no longer significantly predicted fasting RLP-C, although WHR remained a predictor of postprandial RLP-C (P = 0.002). Plasma TG was strongly associated with both fasting and postprandial RLP-C (P < 0.001). In conclusion, plasma RLP-C concentrations are mainly associated with plasma TG concentrations. Interestingly, the high-fat diet was more effective at decreasing fasting RLP-C concentrations in obese participants than the low-fat diet.

^* To whom correspondence should be addressed. E-mail: anneke.vanhees{at}hb.unimaas.nl.

Manuscript received 12 June 2008. Initial review completed 29 July 2008. Revision accepted 5 October 2008.