Abstract

Background and aims Non-fasting blood sampling is increasingly recommended for routine lipid testing in cardiovascular disease risk assessment. However, these recommendations are mainly based on associations between lipid levels and self-reported time since the last meal in epidemiological studies. The aim of the present study was to explore the time-resolved variation in lipoproteins and inflammatory marker concentrations during the postprandial and postabsorptive period, in males and females ingesting a standard breakfast meal.

Methods We used data from a trial where 34 normal-weighted subjects aged 20-30 y were included. Subjects fasted 12 hours, had blood sampled at baseline, then consumed a standardized breakfast meal, and had blood sampled 13 more times over the next 24 hours. NMR metabolomics was used to quantify lipoprotein subclasses and various biomarkers, and ELISA to analyze VCAM-1, ICAM-1, E-selectin, and IL-6. We characterized the postprandial and postabsorptive responses using visualizations and non-linear mixed effects models.

Results Six VLDL subclasses increased by 11-429% within 2-4 hours postprandially before returning to baseline levels, followed by another increase 8-10 hours after intake of the breakfast meal. IDL and three LDL subclasses increased around 10-12% over 24 hours. Four HDL subclasses showed an inverse association with VLDL subclasses, reaching their lowest levels about 1 hour after the meal and peaking after 8-10 hours with a 5-15% increase from baseline. Participants had an average increase of 325% in IL-6 ten hours after breakfast, while other inflammatory biomarkers showed little change over time. For most biomarkers, males generally exhibited higher baseline concentrations compared to females, however the responses over time remained similar.

Conclusions We observed small-to-moderate changes in plasma concentrations of most biomarkers in the postprandial and postabsorptive phases. Non-fasting lipid testing is likely a viable option for CVD risk assessment, as recommended by recent guidelines and consensus statements.

Competing Interest Statement

All authors have completed the ICMJE uniform disclosure form and declare the following conflicts of interest. Dr. Holven has received personal fees from Sanofi and Ultragenyx, none of which are related to the content of this manuscript. Dr. Christensen has received personal fees from Novo Nordisk and Falck Helse, not related to the content of this manuscript. The other authors have no financial relationships relevant to disclose.

Clinical Trial

NCT04989478

Funding Statement

The Postprandial Metabolism study's data collection was performed at the Research Unit for Health Surveys at the University of Bergen, which received funding from the Trond Mohn Foundation (grant ID BFS2017TMT02). The study was part of the Mohn Nutrition Research Laboratory, which received support from the Trond Mohn Foundation, the University of Bergen and Haukeland University Hospital. The present analysis was conducted at the University of Oslo, with additional support from the Throne-Holst Foundation for Nutrition Research and the university of Oslo.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The present study was registered at ClinicalTrials.gov (NCT number 04989478), conducted in accordance with the Declaration of Helsinki, and approved by the Regional Committee for Research Ethics for the Western part of Norway, located at the University of Bergen (REK 236654). Participants signed a consent form prior to engaging in the study and had the chance to withdraw from the study at any time.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Footnotes

E-mails: Silje-Marie Jensen; siljemariejengmail.com, Kirsten B. Holven; k.b.holvenmedisin.uio.no; Stine M. Ulven; smulvenmedisin.uio.no; Åslaug Matre Anfinsen; Aslaug.Matreuib.no; Jutta Dierkes; Jutta.Dierkesuib.no; Vegard Lysne; vegard.lysnehelsedir.no;

Data Availability

All data produced in the present work are contained in the manuscript.

AbbreviationsBMIbody mass indexCEcholesteryl estersCcholesterolCVDcardiovascular diseaseELISAenzyme-linked immunosorbent assayFCfree cholesterolGlycAglycoprotein acetylsHDLhigh-density lipoproteinICAM-1intercellular adhesion molecule-1IL-6interleukin-6LDLlow-density lipoproteinLlargeMmediumNMRnuclear magnetic resonancePparticlesPLphospholipidsSsmallTGtriglyceridesVLDLvery-low-density lipoproteinVCAM-1vascular cell adhesion molecule-1XXLextremely largeXLvery large