Postprandial hyperlipidemia: the search for the atherogenic lipoprotein

Abstract

Postprandial lipemia provides a daily state of challenge to triglyceride transport. A poor ability to cope with this challenge, i.e. a low triglyceride metabolic capacity, is likely to increase risk of cardiovascular disease because it provides ample opportunity for cholesteryl esters to be shunted from LDL and HDL into former triglyceride-rich particles, converting them into potentially atherogenic agents. Shunting of cholesteryl esters into triglyceride-rich lipoproteins appears to be inversely related to triglyceride metabolic capacity, and is indicated by the fasting lipoprotein constellation most frequently associated with coronary artery disease: low HDL cholesterol and a preponderance of small-sized HDL and LDL.