Atherosclerosis 171 (2003) 327–336 Postprandial hyperlipidemia: another correlate of the “hypertriglyceridemic waist” phenotype in men Patricia Blackburn a , Benoˆ ıt Lamarche b,c , Charles Couillard b,c , Agnès Pascot a , Nathalie Bergeron c , Denis Prud’homme d , Angelo Tremblay c,e , Jean Bergeron b , Isabelle Lemieux a , Jean-Pierre Després a,b,c,∗ a Québec Heart Institute, Laval Hospital Research Center, 2725 Chemin Ste-Foy, Pavilion Marguerite-D’Youville, 4th Floor, Ste-Foy, Que., Canada G1V 4G5 b LipidResearch Center, CHUL Research Center, Ste-Foy, Que., Canada G1V4G2 c Institute on Nutraceuticals and Functional Foods, Laval University, Ste-Foy, Que., Canada G1K 7P4 d School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ont., Canada e Divisionof Kinesiology, Faculty of Medicine, Laval University, Ste-Foy, Que., Canada G1K 7P4 Received 18 August 2002; received in revised form 24 March 2003; accepted 16 June 2003 Abstract Fasting hypertriglyceridemia has been reported to be predictive of an exaggerated triglyceride (TG) response to an oral fat load. Abdominal obesity has also been associated with postprandial hyperlipidemia. The objective of the present study was to quantify the contribution of abdominal obesity and fasting hypertriglyceridemia to the magnitude of postprandial lipemia. For that purpose, potential differences in postprandial TG-rich lipoprotein (TRL) levels were examined among men characterized by the absence/presence of the “hypertriglyceridemic waist” phenotype following a standardized breakfast with a high fat content (64% calories as fat). Sixty-nine men (mean age ±S.D.: 45.1 ±10.5 years) were classified according to waist girth (< 90 or ≥ 90 cm) and fasting TG concentrations (< 2.0 or ≥ 2.0 mmol/l). Subjects characterized by “hypertriglyceridemic waist” (waist ≥ 90 cm and fasting TG ≥ 2.0 mmol/l) showed the highest TRL-TG concentrations (P< 0.0001) throughout the entire postprandial period (8 h) as well as elevated concentrations of apolipoprotein (apo) B-48 and apo B-100 in all TRL fractions (large, medium and small) compared to subjects with low fasting TG levels who had waist girth values either above or below 90 cm. These higher postprandial TRL-TG levels among carriers of the “hypertriglyceridemic waist” phenotype also led to significantly greater postprandial TG-total area under the curve (AUC) in total TRLs resulting mainly from the increased concentrations of large- and medium-sized TRLs. Furthermore, subjects characterized by the “hypertriglyceridemic waist” phenotype displayed higher fasting insulin concentrations and postprandial insulin AUC compared to men with low fasting plasma TG levels and low waist girth values. In conclusion, results of the present study indicate that postprandial hyperlipidemia is associated with the simultaneous presence of abdominal obesity and elevated fasting TG concentrations: a condition that we have described as the “hypertriglyceridemic waist” phenotype. © 2003 Elsevier Ireland Ltd. All rights reserved. Keywords: Postprandial lipemia; Hypertriglyceridemic waist phenotype; Insulin; Apolipoproteins; Visceral obesity 1. Introduction Obesity, especially visceral obesity, has been associated with metabolic abnormalities characterizing the insulin re- sistance syndrome [1]. For instance, studies have shown that individuals with an excess visceral adipose tissue (AT) accumulation have an unfavorable plasma lipoprotein–lipid ∗ Corresponding author. Tel.: +1-418-656-4863; fax: +1-418-656-4610. E-mail address: jean-pierre.despres@crhl.ulaval.ca (J.-P. Despr´ es). profile, which included fasting hypertriglyceridemia, the presence of small, dense LDL particles, reduced HDL cholesterol levels leading to a markedly increased choles- terol/HDL cholesterol ratio, elevated apolipoprotein (apo) B concentrations as well as a disturbed plasma glucose–insulin homeostasis compared to nonobese subjects [1]. Alterations in the lipoprotein–lipid profile found among viscerally obese patients are not limited to the fasting state as postprandial hyperlipidemia is another abnormality asso- ciated with abdominal obesity [2,3]. Indeed, we have previ- ously shown that an expanded visceral AT compartment is an 0021-9150/$ – see front matter © 2003 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.atherosclerosis.2003.06.001