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Publications

Journal Article Ahead of print

PubMed: 41588896 DOI: 10.2174/0115701611390916251104053059

Hellenic Postprandial Lipemia Study (HPLS): A Prospective Cohort Trial on the Effect of Statins on Postprandial Hypertriglyceridemia.

Curr Vasc Pharmacol

Authors: Genovefa D Kolovou, Theodoros Katsikas, Petros Kalogeropoulos, Dimitris Panaretos, Vasiliki Giannakopoulou, Vana Kolovou, Stella Iraklianou, Sotiria Limberi, Vasileios Giannaris, Anna Kounali, Niki Katsiki, Despina Perrea, Katerina Anagnostopoulou, Georgios Goumas, Evangelia Siami, Peggy Kostakou, Dimitri P Mikhailidis, Gerald F Watts, Pablo Pérez-Martínez, Jose Lopez-Miranda, Samia Mora, Børge Nordestgaard, Dennis V Cokkinos, Nikolaos Tentolouris, Helen Bilianou

Affiliations

  • Department of Cardiology, Cardiometabolic Center, Lipoprotein Apheresis and Lipid Disorders Clinic, Metropolitan Hospital, Athens, Greece.
  • Department of Medicine, Sotiria Hospital, Athens, Greece.
  • Department of Statistics and Insurance Science, School of Economic Sciences, University of Western Macedonia, Grevena, Greece.
  • Department of Cardiology, Tzanio Hospital, Piraeus, Greece.
  • Emeritus Director, Department of Medicine, Tzanio Hospital, Piraeus, Greece.
  • Department of Cardiology, Thriasio Hospital, Aspropirgos, Greece.
  • Department of ICU, "KAT" General Hospital, Athens, Greece.
  • Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece.
  • School of Medicine, European University Cyprus, Nicosia, Cyprus.
  • Emeritus Professor, Laboratory of Experimental Surgery and Surgical Research 'N.S. Christeas', National and Kapodistrian University of Athens Medical School, Athens, Greece.
  • Molecular Genetics Department, Genomedica S.A. Piraeus, Greece.
  • Cardiology Clinic, Athens Euroclinic, Athens, Greece.
  • First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece.
  • Consultant Cardiologist-Heart Failure Specialist, Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Alexandra Hospital, Athens, Greece.
  • Department of Clinical Biochemistry, Royal Free Hospital campus, University College London Medical School, University College London (UCL), London, UK.
  • Cardiometabolic Service, Departments of Cardiology and Internal Medicine, Royal Perth Hospital, School of Medicine, University of Western Australia, Australia.
  • Lipid and Atherosclerosis Unit, IMIBIC/Reina Sofia University Hospital/University of Cordoba, and CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Spain.
  • Center for Lipid Metabolomics, Divisions of Preventive and Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
  • Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
  • Clinical, Translational and Experimental Surgery Research Centre, Biomedical Research Foundation, Academy of Athens, Athens, Greece.
  • Department of Cardiology "Tzaneio" General Hospital, Piraeus, Greece.

Abstract

INTRODUCTION/OBJECTIVE

Both fasting and postprandial hypertriglyceridemia are associated with atherosclerotic cardiovascular disease (ASCVD). The Hellenic Postprandial Lipemia Study (HPLS, NCT02163044) is the largest prospective cohort trial assessing the effects of statin therapy on postprandial lipemia.

METHODS

Individuals at high or very high risk for ASCVD were evaluated, and their characteristics were recorded at baseline (Visit 1). At Visit 2 (2-4 weeks after Visit 1) and Visit 3 (3-4 months after Visit 2), serum triglyceride (TG) levels were measured after a 12-hour fast (fTG) as well as 4 hours after the ingestion of a commercially available oral fat tolerance test meal (pTG). After Visit 2, all individuals were treated with a statin.

RESULTS AND DISCUSSION

Among 900 participants, 699 completed all 3 visits, and of these, 209 (29.9%) had an abnormal pTG response. The mean (standard deviation, SD) total- and low-density lipoprotein cholesterol concentrations were 225 (50) and 148 (46) mg/dL at Visit 1, 231 (42) and 156 (40) mg/dL at Visit 2, and 171 (28) and 101 (27) mg/dL at Visit 3. At Visit 2, the mean fTG level was 127 (45) mg/dL and pTG was 188 (73) mg/dL with a mean difference of 58 mg/dL (P<0.001). At Visit 3, the mean fTG concentration was 110 (40) mg/dL, while pTG was 140 (54) mg/dL (mean difference: 29 mg/dL; P<0.001). Fasting glucose levels had no impact on pTG response in statin-treated individuals with abnormal postprandial lipemia.

CONCLUSION

Nearly 30% of individuals at high-/very high-risk for ASCVD had postprandial hypertriglyceridemia. Statin treatment normalized abnormal postprandial lipemia in 75.6% of participants, and decreased pTG concentration even in those with normal fTG levels.

MeSH

Dyslipidemias, Hypertriglyceridemia, Therapeutics, Hydroxymethylglutaryl-Coa Reductase Inhibitors, Triglycerides