Postprandial hyperlipidemia is a condition which represent an abnormal increase in lipoproteins or the persistence of this increase after meal intake. A delayed clearance of postprandial lipoproteins from the plasma is due to the deranged catabolism of chylomicron and very-low-density lipoprotein remnants and may play a role in the etiology of premature atherosclerotic disorders.
Previously, we have demonstrated that the measuring a remnant-like particles cholesterol (RLP-C) after oral fat loading test (30g fat/m² body surface) was a good marker for the assessment of postprandial hyperlipidemia. Among type 2 diabetic subjects, obvious difference was not detected in the changes of RLP-C after oral fat loading test compared to non-diabetic subjects as long as initial plasma triglyceride and RLP-C level were the same range. The negative relationship between high-density lipoprotein cholesterol (HDL-C) and area under the curve (AUC) of triglyceride by oral fat loading to non-diabetic normolipidemic subjects was more prominent than that between HDL-C and fasting plasma triglyceride (r=-0.574, p=0.03 vs. ns). This tendency was also detected strongly in diabetes and the correlation coefficient predicted between HDL-C and TG AUC was -0.951 (p=0.0014) in type 2 diabetic normolipidemic patients. By the administration of bezafibrate (400mg/day) to 7 of normolipidemic volunteers for 4 weeks, RLP-C increased from 4.8±0.6mg/dl to 5.8±0.3mg/dl but TG AUC in oral fat loading test was decreased by 16.4% and peak time of RLP-C was shortened and recovery of RLP-C to the initial value at 6 hours after fat loading was btained after 4 weeks of bezafibrate administration.
As a whole, fat loading test is useful to detect a latent abnormal remnant metabolism and furthermore it give us more information on changes in lipoprotein profile than measurements of fasting plasma lipid. Subjects with lone hypoalfalipoproteinemia are presumably the candidate for oral fat loading test because some of them may represent hypoalfalipoproteinemia as a reflection of postprandial hyperlipidemia.

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