The Influence of Visceral Fat on the Postprandial Lipemic Response in Men with Paraplegia

Background: Postprandial lipemia (PPL) is associated with vascular dysfunction and may be an etiologic factor in the progression of atherogenic cardiovascular disease. Objective: In 10 men with paraplegia and 10 able-bodied men, the magnitude of the PPL responses and the relationship of abdominal adiposity and the PPL responses were determined. Methods: Anthropometrics, dual energy x-ray absorptiometry, and abdominal ultrasonography were performed to determine visceral fat and total body fat. A fasting lipid profile was performed. A high-fat milkshake (1.3 g fat/kg body mass) was administered with serum collected at baseline and at 2, 4, and 6 hours after the test meal for subsequent measurement of triglyceride. The triglyceride response was determined by the area under the triglyceride curve. Results: No significant differences were noted between the groups in fasting lipid values or in measures of visceral fat. Total body fat tended to be higher in men with paraplegia than in able-bodied men (34.9 ± 10.0 vs. 27.3 ± 6.7%, p  =  0.07). No significant difference between the groups was observed in triglyceride response. In men with paraplegia, visceral fat was strongly associated with the triglyceride (r  =  0.8, p  =  0.005), fasting low-density lipoprotein (r  =  0.66, p  =  0.04), and triglyceride responses (r  =  0.80, p  =  0.005); a significant relationship was not found between fasting high-density lipoprotein and any measure of adiposity. In men with paraplegia, triglyceride response was positively related to all measures of abdominal adiposity. Conclusion: Visceral abdominal fat was related to delayed triglyceride clearance after a fat load, which may contribute to coronary heart disease (CHD) risk and progression of vascular disease in men with paraplegia.