Lipid Insights

Aim: To assess the response of postprandial (PP) hypertriglyceridemia to genfibrozil in healthy male subjects with isolated low HDL-Cholesterol but without the metabolic syndrome (MS).

Patients and methods: 14 male subjects with isolated low HDL (HDL-C ≤ 33), normal fasting triglycerides and LDL-C levels and without any feature of the MS, were studied. 13 male subjects with HDL-C > 38 mg/dl served as controls. They also had normal fasting triglycerides and LDL-C levels and without any feature of the MS. The 2 groups were statistically similar with respect to age, blood pressure, BMI, body fat composition, waist circumference, waist to hip ratio, fasting insulin, fasting and PP blood sugar, baseline fasting TG level and baseline LDL-C. Postprandial TG levels were measured at 2, 4, and 6 hours following a morning meal. Ten of the patients with PP hypertriglyceridemia were treated with gemfibrozil 600 mg PO twice/day for one month.

Results: Patients had markedly higher levels of the peak PP TG at 4 hours compared to controls (296.0 ± 37.7 vs. 206.7 ± 29.9 mg/dl; P < 0.05) the other two postprandial levels were also higher in patients but the difference was not significant. Treatment with gemfibrozil significantly decreased the levels of fasting and postprandial TG and increased HDL-C by around 3.6 mg/dl (11.7%) without affecting LDL-C.

Conclusion: Postprandial increase in serum TG may be present in patients with isolated HDL-C without the MS. Treatment of patients with PP hypertriglyceridemia with gemfibrozil improves the low HDL-C and postprandial rise in TG.