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Predictors of postprandial triacylglycerol response in children: the Columbia University Biomarkers Study^1,2,3

¹ From the Departments of Pediatrics and Medicine, Columbia University, New York.

Background: Predictors of postprandial lipemia have not been explored in children.

Objective: Our objective was to determine whether the postprandial triacylglycerol response is associated with low HDL-cholesterol and high fasting triacylglycerol concentrations and family history of early-onset ischemic heart disease (IHD) in children.

Design: We administered a standardized fat load (52.5 g fat/m²) to 60 children (mean age: 14.0 y), 20 with and 40 without a family history of early-onset IHD, and to 29 mothers, all recruited from families enrolled in the Columbia University Biomarkers Study. Plasma lipid and retinyl palmitate concentrations were measured in the fasting state and 3, 6, and 8 h after the oral fat load.

Results: In children, postprandial lipemia, as indicated by the incremental area under the triacylglycerol response curve, was associated with elevated fasting triacylglycerol concentrations (1.13 mmol/L; P < 0.01), with low fasting HDL-cholesterol concentrations (0.91 mmol/L; P < 0.01), and with the combination of low HDL-cholesterol and high triacylglycerol concentrations (P < 0.05). Family history of IHD, baseline LDL-cholesterol concentration, and apolipoprotein E genotype were not associated with the postprandial triacylglycerol or retinyl palmitate response. The mothers had fasting triacylglycerol concentrations similar to those of their children but a more prolonged response with higher triacylglycerol concentrations at 6 and 8 h (P < 0.01 and P < 0.05, respectively).

Conclusions: In children, a delayed postprandial triacylglycerol response to a fat load is associated with the combination of high fasting triacylglycerol and low HDL-cholesterol concentrations. Predictors of postprandial triacylglycerol concentrations may be similar in children and adults.

Key Words: Atherosclerosis • postprandial period • triacylglycerol • children • coronary heart disease • HDL cholesterol • risk factors • ischemic heart disease • Columbia University Biomarkers Study

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