<trans-title xml:lang="en"/>_West China Medical Journal

Authors：

刘雯 ¹ ,  苗佳 ¹ , 王佑娟 ²

1. ;
2. ;

Corresponding author：

苗佳, Email: miaosiyi1971@163.com

Keywords：

脂肪餐负荷试验; 餐后高脂血症; 心血管疾病; 胰岛素抵抗; 2 型糖尿病

DOI：

10.7507/1002-0179.201507038

Video：

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Abstract Full text Figures/Tables Video References Cited by

临床常规血脂检查要求采集清晨空腹血，但现实生活中人体绝大部分时间处于餐后状态，仅检测空腹血脂水平不足以反映机体真实的脂代谢全貌。近年来国内外较多研究通过脂肪餐负荷试验，探讨了餐后血脂的变化过程及其与血管内皮病变、心血管疾病及胰岛素抵抗、2 型糖尿病等发生发展的相关性。本文对脂肪餐负荷试验及餐后高脂血症与相关疾病的研究进行了综述。

Citation： 刘雯, 苗佳, 王佑娟. . West China Medical Journal, 2017, 32(3): 465-470. doi: 10.7507/1002-0179.201507038 Copy

1.	诸骏仁, 高润霖, 赵水平, 等. 中国成人血脂异常防治指南(2016年修订版). 中国循环杂志, 2016(10): 937-953.
2.	Boquist S, Ruotolo G, Tang R,et al. Alimentary lipemia, postprandial triglyceride-rich lipoproteins, and common carotid intima-media thickness in healthy, middle-aged men. Circulation, 1999, 100(7): 723-728.
3.	Sharrett AR, Chambless LE, Heiss G,et al. Association of postprandial triglyceride and retinyl palmitate resposes with asymptomatic carotid artery atherosclerosis in middle-aged men and women. The Atherosclerosis Risk in Communities Study. Arterioscler Thromb Vasc Biol, 1995, 15(12): 2122-2129.
4.	Maraki M, Aggelopoulou N, Christodoulou N,et al. Validity of abbreviated oral fat tolerance tests for assessing postprandial lipemia. Clin Nutr, 2011, 30(6): 852-857.
5.	刘玲, 赵水平, 程艳春, 等. 检测高脂餐后高甘油三酯血症的最佳时间切点. 中华内分泌代谢杂志, 2004, 20(1): 23-25.
6.	张原力, 游凯, 方圻. 脂餐后血清甘油三酯代谢异常作为冠心病独立危险因素的探讨. 中华心血管病杂志, 1998, 26(2): 89.
7.	刘悦, 沈建国. 老年糖尿病患者脂肪餐后甘油三酯的变化及其对血管内皮功能的影响. 中国老年学杂志, 2014(17): 4775-4777.
8.	Mihas C, Kolovou GD, Mikhailidis DP,et al. Diagnostic value of postprandial triglyceride testing in healthy subjects: a meta-analysis. Curr Vasc Pharmacol, 2011, 9(3): 271-280.
9.	Hald EM, Brækkan SK, Vik A,et al. Postprandial lipemia is not increased in patients with previous unprovoked venous thromboembolism. J Clin Lipidol, 2013, 7(1): 48-55.
10.	Kolovou GD, Mikhailidis DP, Kovar J,et al. Assessment and clinical relevance of non-fasting and postprandial triglycerides: an expert panel statement. Curr Vasc Pharmacol, 2011, 9(3): 258-270.
11.	Teno S, Uto Y, Nagashima H,et al. Association of postprandial hypertriglyceridemia and carotid intima-media thickness in patients with type 2 diabetes. Diabetes Care, 2000, 23(9): 1401-1406.
12.	Albert MA, Glynn RJ, Buring J,et al. Impact of traditional and novel risk factors on the relationship between socioeconomic status and incident cardiovascular events. Circulation, 2006, 114(24): 2619-2626.
13.	Ambrose JA, Singh M. Pathophysiology of coronary artery disease leading to acute coronary syndromes. F1000Prime Rep, 2015, 7: 08.
14.	Tesfamariam B, Defelice AF. Endothelial injury in the initiation and progression of vascular disorders. Vascul Pharmacol, 2007, 46(4): 229-237.
15.	Anderson TJ, Gerhard MD, Meredith IT,et al. Systemic nature of endothelial dysfunction in atherosclerosis. Am J Cardiol, 1995, 75(6): 71B-74B.
16.	Petnehazy T, Stokes KY, Russell JM,et al. Angiotensin II type-1 receptor antagonism attenuates the inflammatory and thrombogenic responses to hypercholesterolemia in venules. Hypertension, 2005, 45(2): 209-215.
17.	Steinberg D. Thematic review series: the pathogenesis of atherosclerosis. An interpretive history of the cholesterol controversy: part II: the early evidence linking hypercholesterolemia to coronary disease in humans. J Lipid Res, 2005, 46(2): 179-190.
18.	Austin MA. Plasma triglyceride and coronary heart disease. Arterioscler Thromb, 1991, 11(1): 2-14.
19.	Bae JH, Bassenge E, Kim KB,et al. Postprandial hypertriglyceridemia impairs endothelial function by enhanced oxidant stress. Atherosclerosis, 2001, 155(2): 517-523.
20.	Blendea MC, Bard M, Sowers JR,et al. High-fat meal impairs vascular compliance in a subgroup of young healthy subjects. Metabolism, 2005, 54(10): 1337-1344.
21.	林金秀, 柴大军, 吴可贵, 等. 正常人餐后甘油三酯动态代谢对血清一氧化氮和血浆内皮素1的影响. 中国动脉硬化杂志, 2001, 9(3): 227-230.
22.	张绘莉, 赵水平, 刘玲. 冠心病患者摄入不同量脂肪餐后血脂水平的变化及其对血管内皮功能的影响. 中国循环杂志, 2001, 16(1): 24-26.
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24.	Nordestgaard BG, Benn M, Schnohr P,et al. Nonfasting triglycerides and risk of myocardial infarction, ischemic heart disease, and death in men and women. JAMA, 2007, 298(3): 299-308.
25.	Bansal S, Buring JE, Rifai N,et al. Fasting compared with nonfasting triglycerides and risk of cardiovascular events in women. JAMA, 2007, 298(3): 309-316.
26.	Freiberg JJ, Tybjaerg-Hansen A, Jensen JS,et al. Nonfasting triglycerides and risk of ischemic stroke in the general population. JAMA, 2008, 300(18): 2142-2152.
27.	Zilversmit DB. A proposal linking atherogenesis to the interaction of endothelial lipoprotein lipase with triglyceride-rich lipoproteins. Circ Res, 1973, 33(6): 633-638.
28.	Ross R, Harker L. Hyperlipidemia and atherosclerosis. Science, 1976, 193(4258): 1094-1100.
29.	Cohn JS, Johnson EJ, Millar JS,et al. Contribution of apoB-48 and apoB-100 triglyceride-rich lipoproteins (TRL) to postprandial increases in the plasma concentration of TRL triglycerides and retinyl esters. J Lipid Res, 1993, 34(12): 2033-2040.
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31.	Schneeman BO, Kotite L, Todd KM,et al. Relationships between the responses of triglyceride-rich lipoproteins in blood plasma containing apolipoproteins B-48 and B-100 to a fat-containing meal in normolipidemic humans. Proc Natl Acad Sci U S A, 1993, 90(5): 2069-2073.
32.	Moreton JR. Chylomicronemia, fat tolerance, and atherosclerosis. International Journal of Epidemiology, 1950, 35(3): 373-384.
33.	Zilversmit DB. Atherogenesis: a postprandial phenomenon. Circulation, 1979, 60(3): 473-485.
34.	Anderson TJ. Assessment and treatment of endothelial dysfunction in humans. J Am Coll Cardiol, 1999, 34(3): 631-638.
35.	Karpe F, Steiner G, Uffelman K,et al. Postprandial lipoproteins and progression of coronary atherosclerosis. Atherosclerosis, 1994, 106(1): 83-97.
36.	Barritt DW. Alimentary lipaemia in men with coronary artery disease and in controls. Br Med J, 1956, 2(4993): 640-644.
37.	张若青, 杨春燕, 李洁冰, 等. 餐后血脂代谢异常与冠状动脉病变严重程度关系研究. 河北医药, 2009, 31(13): 1556-1558.
38.	杨胜茹, 郜舟顺, 赵志强, 等. 空腹血脂正常的冠心病患者高、低脂肪餐后血脂的变化. 天津医药, 2009, 37(3): 215-216.
39.	Boquist S, Ruotolo G, Tang R,et al. Alimentary lipemia, postprandial triglyceride-rich lipoproteins, and common carotid intima-media thickness in healthy, middle-aged men. Circulation, 1999, 100(7): 723-728.
40.	Langsted A, Freiberg JJ, Tybjaerg-Hansen A,et al. Nonfasting cholesterol and triglycerides and association with risk of myocardial infarction and total mortality: the Copenhagen City Heart Study with 31 years of follow-up. J Intern Med, 2011, 270(1): 65-75.
41.	Lindman AS, Veierød MB, Tverdal A,et al. Nonfasting triglycerides and risk of cardiovascular death in men and women from the Norwegian Counties Study. Eur J Epidemiol, 2010, 25(11): 789-798.
42.	Fletcher B, Lamendola C. Insulin resistance syndrome. J Cardiovasc Nurs, 2004, 19(5): 339-345.
43.	Mcgarry JD. Banting lecture 2001: dysregulation of fatty acid metabolism in the etiology of type 2 diabetes. Diabetes, 2002, 51(1): 7-18.
44.	Smith-Marsh D. Pharmacological strategies for preventing type 2 diabetes in patients with impaired glucose tolerance. Drugs Today (Barc), 2013, 49(8): 499-507.
45.	Lewis GF, O'meara NM, Soltys PA,et al. Fasting hypertriglyceridemia in noninsulin-dependent diabetes mellitus is an important predictor of postprandial lipid and lipoprotein abnormalities. J Clin Endocrinol Metab, 1991, 72(4): 934-944.
46.	Unger RH, Zhou YT. Lipotoxicity of beta-cells in obesity and in other causes of fatty acid spillover. Diabetes, 2001, 50 Suppl 1(2): S118.
47.	Randle PJ. Regulatory interactions between lipids and carbohydrates: the glucose fatty acid cycle after 35 years. Diabetes Metab Rev, 1998, 14(4): 263-283.
48.	Mcgarry JD. What if minkowski had been ageusic? an alternative angle on diabetes. Science, 1992, 258(583): 766-770.
49.	Koyama K, Chen G, Lee Y,et al. Tissue triglycerides, insulin resistance, and insulin production: implications for hyperinsulinemia of obesity. Am J Physiol, 1997, 273(4 Pt 1): E708-E713.
50.	Lee Y, Hirose H, Ohneda M,et al. Beta-cell lipotoxicity in the pathogenesis of non-insulin-dependent diabetes mellitus of obese rats: impairment in adipocyte-beta-cell relationships. Proc Natl Acad Sci U S A, 1994, 91(23): 10878-10882.
51.	Marceau P, Biron S, Hould FS,et al. Liver pathology and the metabolic syndrome X in severe obesity. J Clin Endocrinol Metab, 1999, 84(5): 1513-1517.
52.	Picard F, Boivin A, Lalonde J,et al. Resistance of adipose tissue lipoprotein lipase to insulin action in rats fed an obesity-promoting diet. Am J Physiol Endocrinol Metab, 2002, 282(2): E412-E418.
53.	Schrezenmeir J, Keppler I, Fenselau S,et al. The phenomenon of a high triglyceride response to an oral lipid load in healthy subjects and its link to the metabolic syndrome. Ann N Y Acad Sci, 1993, 683(1): 302-314.
54.	Jeppesen J, Hollenbeck CB, Zhou MY,et al. Relation between insulin resistance, hyperinsulinemia, postheparin plasma lipoprotein lipase activity, and postprandial lipemia. Arterioscler Thromb Vasc Biol, 1995, 15(3): 320-324.
55.	Vansant G, Mertens A, Muls E. Determinants of postprandial lipemia in obese women. Int J Obes Relat Metab Disord, 1999, 23(Suppl 1): 14-21.
56.	Hahn PF. ABOLISHMENT OF ALIMENTARY LIPEMIA FOLLOWING INJECTION OF HEPARIN. Science, 1943, 98(2531): 19-20.
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1. 诸骏仁, 高润霖, 赵水平, 等. 中国成人血脂异常防治指南(2016年修订版). 中国循环杂志, 2016(10): 937-953.
2. Boquist S, Ruotolo G, Tang R,et al. Alimentary lipemia, postprandial triglyceride-rich lipoproteins, and common carotid intima-media thickness in healthy, middle-aged men. Circulation, 1999, 100(7): 723-728.
3. Sharrett AR, Chambless LE, Heiss G,et al. Association of postprandial triglyceride and retinyl palmitate resposes with asymptomatic carotid artery atherosclerosis in middle-aged men and women. The Atherosclerosis Risk in Communities Study. Arterioscler Thromb Vasc Biol, 1995, 15(12): 2122-2129.
4. Maraki M, Aggelopoulou N, Christodoulou N,et al. Validity of abbreviated oral fat tolerance tests for assessing postprandial lipemia. Clin Nutr, 2011, 30(6): 852-857.
5. 刘玲, 赵水平, 程艳春, 等. 检测高脂餐后高甘油三酯血症的最佳时间切点. 中华内分泌代谢杂志, 2004, 20(1): 23-25.
6. 张原力, 游凯, 方圻. 脂餐后血清甘油三酯代谢异常作为冠心病独立危险因素的探讨. 中华心血管病杂志, 1998, 26(2): 89.
7. 刘悦, 沈建国. 老年糖尿病患者脂肪餐后甘油三酯的变化及其对血管内皮功能的影响. 中国老年学杂志, 2014(17): 4775-4777.
8. Mihas C, Kolovou GD, Mikhailidis DP,et al. Diagnostic value of postprandial triglyceride testing in healthy subjects: a meta-analysis. Curr Vasc Pharmacol, 2011, 9(3): 271-280.
9. Hald EM, Brækkan SK, Vik A,et al. Postprandial lipemia is not increased in patients with previous unprovoked venous thromboembolism. J Clin Lipidol, 2013, 7(1): 48-55.
10. Kolovou GD, Mikhailidis DP, Kovar J,et al. Assessment and clinical relevance of non-fasting and postprandial triglycerides: an expert panel statement. Curr Vasc Pharmacol, 2011, 9(3): 258-270.
11. Teno S, Uto Y, Nagashima H,et al. Association of postprandial hypertriglyceridemia and carotid intima-media thickness in patients with type 2 diabetes. Diabetes Care, 2000, 23(9): 1401-1406.
12. Albert MA, Glynn RJ, Buring J,et al. Impact of traditional and novel risk factors on the relationship between socioeconomic status and incident cardiovascular events. Circulation, 2006, 114(24): 2619-2626.
13. Ambrose JA, Singh M. Pathophysiology of coronary artery disease leading to acute coronary syndromes. F1000Prime Rep, 2015, 7: 08.
14. Tesfamariam B, Defelice AF. Endothelial injury in the initiation and progression of vascular disorders. Vascul Pharmacol, 2007, 46(4): 229-237.
15. Anderson TJ, Gerhard MD, Meredith IT,et al. Systemic nature of endothelial dysfunction in atherosclerosis. Am J Cardiol, 1995, 75(6): 71B-74B.
16. Petnehazy T, Stokes KY, Russell JM,et al. Angiotensin II type-1 receptor antagonism attenuates the inflammatory and thrombogenic responses to hypercholesterolemia in venules. Hypertension, 2005, 45(2): 209-215.
17. Steinberg D. Thematic review series: the pathogenesis of atherosclerosis. An interpretive history of the cholesterol controversy: part II: the early evidence linking hypercholesterolemia to coronary disease in humans. J Lipid Res, 2005, 46(2): 179-190.
18. Austin MA. Plasma triglyceride and coronary heart disease. Arterioscler Thromb, 1991, 11(1): 2-14.
19. Bae JH, Bassenge E, Kim KB,et al. Postprandial hypertriglyceridemia impairs endothelial function by enhanced oxidant stress. Atherosclerosis, 2001, 155(2): 517-523.
20. Blendea MC, Bard M, Sowers JR,et al. High-fat meal impairs vascular compliance in a subgroup of young healthy subjects. Metabolism, 2005, 54(10): 1337-1344.
21. 林金秀, 柴大军, 吴可贵, 等. 正常人餐后甘油三酯动态代谢对血清一氧化氮和血浆内皮素1的影响. 中国动脉硬化杂志, 2001, 9(3): 227-230.
22. 张绘莉, 赵水平, 刘玲. 冠心病患者摄入不同量脂肪餐后血脂水平的变化及其对血管内皮功能的影响. 中国循环杂志, 2001, 16(1): 24-26.
23. 陈玲, 柴大军, 林新霖, 等. 高分辨率超声研究餐后高甘油三酯血症对正常人血管内皮功能的损伤. 中国超声医学杂志, 2001, 17(11): 848-851.
24. Nordestgaard BG, Benn M, Schnohr P,et al. Nonfasting triglycerides and risk of myocardial infarction, ischemic heart disease, and death in men and women. JAMA, 2007, 298(3): 299-308.
25. Bansal S, Buring JE, Rifai N,et al. Fasting compared with nonfasting triglycerides and risk of cardiovascular events in women. JAMA, 2007, 298(3): 309-316.
26. Freiberg JJ, Tybjaerg-Hansen A, Jensen JS,et al. Nonfasting triglycerides and risk of ischemic stroke in the general population. JAMA, 2008, 300(18): 2142-2152.
27. Zilversmit DB. A proposal linking atherogenesis to the interaction of endothelial lipoprotein lipase with triglyceride-rich lipoproteins. Circ Res, 1973, 33(6): 633-638.
28. Ross R, Harker L. Hyperlipidemia and atherosclerosis. Science, 1976, 193(4258): 1094-1100.
29. Cohn JS, Johnson EJ, Millar JS,et al. Contribution of apoB-48 and apoB-100 triglyceride-rich lipoproteins (TRL) to postprandial increases in the plasma concentration of TRL triglycerides and retinyl esters. J Lipid Res, 1993, 34(12): 2033-2040.
30. Karpe F, Bell M, Björkegren J,et al. Quantification of postprandial triglyceride-rich lipoproteins in healthy men by retinyl ester labeling and simultaneous measurement of apolipoproteins B-48 and B-100. Arterioscler Thromb Vasc Biol, 1995, 15(2): 199-207.
31. Schneeman BO, Kotite L, Todd KM,et al. Relationships between the responses of triglyceride-rich lipoproteins in blood plasma containing apolipoproteins B-48 and B-100 to a fat-containing meal in normolipidemic humans. Proc Natl Acad Sci U S A, 1993, 90(5): 2069-2073.
32. Moreton JR. Chylomicronemia, fat tolerance, and atherosclerosis. International Journal of Epidemiology, 1950, 35(3): 373-384.
33. Zilversmit DB. Atherogenesis: a postprandial phenomenon. Circulation, 1979, 60(3): 473-485.
34. Anderson TJ. Assessment and treatment of endothelial dysfunction in humans. J Am Coll Cardiol, 1999, 34(3): 631-638.
35. Karpe F, Steiner G, Uffelman K,et al. Postprandial lipoproteins and progression of coronary atherosclerosis. Atherosclerosis, 1994, 106(1): 83-97.
36. Barritt DW. Alimentary lipaemia in men with coronary artery disease and in controls. Br Med J, 1956, 2(4993): 640-644.
37. 张若青, 杨春燕, 李洁冰, 等. 餐后血脂代谢异常与冠状动脉病变严重程度关系研究. 河北医药, 2009, 31(13): 1556-1558.
38. 杨胜茹, 郜舟顺, 赵志强, 等. 空腹血脂正常的冠心病患者高、低脂肪餐后血脂的变化. 天津医药, 2009, 37(3): 215-216.
39. Boquist S, Ruotolo G, Tang R,et al. Alimentary lipemia, postprandial triglyceride-rich lipoproteins, and common carotid intima-media thickness in healthy, middle-aged men. Circulation, 1999, 100(7): 723-728.
40. Langsted A, Freiberg JJ, Tybjaerg-Hansen A,et al. Nonfasting cholesterol and triglycerides and association with risk of myocardial infarction and total mortality: the Copenhagen City Heart Study with 31 years of follow-up. J Intern Med, 2011, 270(1): 65-75.
41. Lindman AS, Veierød MB, Tverdal A,et al. Nonfasting triglycerides and risk of cardiovascular death in men and women from the Norwegian Counties Study. Eur J Epidemiol, 2010, 25(11): 789-798.
42. Fletcher B, Lamendola C. Insulin resistance syndrome. J Cardiovasc Nurs, 2004, 19(5): 339-345.
43. Mcgarry JD. Banting lecture 2001: dysregulation of fatty acid metabolism in the etiology of type 2 diabetes. Diabetes, 2002, 51(1): 7-18.
44. Smith-Marsh D. Pharmacological strategies for preventing type 2 diabetes in patients with impaired glucose tolerance. Drugs Today (Barc), 2013, 49(8): 499-507.
45. Lewis GF, O'meara NM, Soltys PA,et al. Fasting hypertriglyceridemia in noninsulin-dependent diabetes mellitus is an important predictor of postprandial lipid and lipoprotein abnormalities. J Clin Endocrinol Metab, 1991, 72(4): 934-944.
46. Unger RH, Zhou YT. Lipotoxicity of beta-cells in obesity and in other causes of fatty acid spillover. Diabetes, 2001, 50 Suppl 1(2): S118.
47. Randle PJ. Regulatory interactions between lipids and carbohydrates: the glucose fatty acid cycle after 35 years. Diabetes Metab Rev, 1998, 14(4): 263-283.
48. Mcgarry JD. What if minkowski had been ageusic? an alternative angle on diabetes. Science, 1992, 258(583): 766-770.
49. Koyama K, Chen G, Lee Y,et al. Tissue triglycerides, insulin resistance, and insulin production: implications for hyperinsulinemia of obesity. Am J Physiol, 1997, 273(4 Pt 1): E708-E713.
50. Lee Y, Hirose H, Ohneda M,et al. Beta-cell lipotoxicity in the pathogenesis of non-insulin-dependent diabetes mellitus of obese rats: impairment in adipocyte-beta-cell relationships. Proc Natl Acad Sci U S A, 1994, 91(23): 10878-10882.
51. Marceau P, Biron S, Hould FS,et al. Liver pathology and the metabolic syndrome X in severe obesity. J Clin Endocrinol Metab, 1999, 84(5): 1513-1517.
52. Picard F, Boivin A, Lalonde J,et al. Resistance of adipose tissue lipoprotein lipase to insulin action in rats fed an obesity-promoting diet. Am J Physiol Endocrinol Metab, 2002, 282(2): E412-E418.
53. Schrezenmeir J, Keppler I, Fenselau S,et al. The phenomenon of a high triglyceride response to an oral lipid load in healthy subjects and its link to the metabolic syndrome. Ann N Y Acad Sci, 1993, 683(1): 302-314.
54. Jeppesen J, Hollenbeck CB, Zhou MY,et al. Relation between insulin resistance, hyperinsulinemia, postheparin plasma lipoprotein lipase activity, and postprandial lipemia. Arterioscler Thromb Vasc Biol, 1995, 15(3): 320-324.
55. Vansant G, Mertens A, Muls E. Determinants of postprandial lipemia in obese women. Int J Obes Relat Metab Disord, 1999, 23(Suppl 1): 14-21.
56. Hahn PF. ABOLISHMENT OF ALIMENTARY LIPEMIA FOLLOWING INJECTION OF HEPARIN. Science, 1943, 98(2531): 19-20.
57. Cryer A. Tissue lipoprotein lipase activity and its action in lipoprotein metabolism. Int J Biochem, 1981, 13(5): 525-541.
58. Wang CS, Hartsuck J, Mcconathy WJ. Structure and functional properties of lipoprotein lipase. Biochimica Et Biophysica Acta, 1992, 1123(1): 1-17.
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