Unit:
Κατεύθυνση Σακχαρώδης Διαβήτης και ΠαχυσαρκίαLibrary of the School of Health Sciences
Author:
Bampalis Vasileios
Supervisors info:
Τεντολούρης Νικόλαος, Καθηγητής, Ιατρική, Ε.Κ.Π.Α.
Κόκκινος Αλέξανδρος, Αναπληρωτής Καθηγητής, Ιατρική, Ε.Κ.Π.Α.
Μακρυλάκης Κωνσταντίνος, Αναπληρωτής Καθηγητής, Ιατρική, Ε.Κ.Π.Α.
Original Title:
Αξιολόγηση των προτυποποιημένων μεθόδων μέτρησης της μεταγευματικής λιπαιμίας και συσχέτιση της μεταγευματικής λιπαιμίας με τον καρδιαγγειακό κίνδυνο του ασθενούς με σακχαρώδη διαβήτη τύπου 2
Translated title:
Evaluation of the standardized measurement methods of postprandial lipemia and the relationship of postprandial lipemia to the cardiovascular risk of the patient with type 2 diabetes mellitus.
Summary:
The relationship between postprandial dyslipidemia, in particular postprandial
hypertriglyceridemia, and cardiovascular risk has been established in the general
population. Patients with type 2 diabetes mellitus (T2DM) have higher postprandial
triglyceridemia levels. It is therefore assumed that, in patients with T2DM, postprandial
lipemia may be associated with increased cardiovascular risk. Its measurement
methods are currently heterogeneous.
The main aim of the present thesis is to investigate the role of postprandial lipemia in
the cardiovascular risk of patients with T2DM and a secondary objective is to evaluate
the standardized methods of postprandial lipemia measurement, both by means of
systematic review.
The search was conducted with pre-defined terms in 6 electronic databases, in 6
relevant scientific journals, within bibliographic references on relevant reviews and by
inquiring a specialist on the subject. The selection of surveys was done according to
pre-defined criteria on a three-level basis, i.e. by reading the title, abstract and full text
in succession. The evaluation for systematic errors of the selected prospective studies
was done with the QUIPS tool.
Regarding the main aim of the dissertation, 41,867 article titles were evaluated and 12
were finally selected. Three of them were related to prospective studies and 9 to crosssectional studies. A further 6 studies concerning the carotid intima-media thickness
(cIMT) as a variable were included for further commentary. Evaluation of 38,572 article
titles with a final selection of 14 was conducted for the secondary aim.12
The 3 prospective studies did not show a correlation between postprandial
hypertriglyceridemia and cardiovascular risk. In 9 retrospective studies, the
corresponding correlation was partly positive and partly neutral. In 5 out of 6 studies that
studied cIMT, there was a consistent positive correlation with the levels of postprandial
triglycerides. Postprandial concentrations of apolipoproteins C2 and E were associated
with cardiovascular risk, but the postprandial concentrations of the other lipidemic
particles or molecules demonstrated a doubtful or absent respective correlation.
Regarding the evaluation of postprandial triglyceridemia measurement methods,
standardized meals with varying compositions showed little to moderate variation,
moderate to good repeatability and satisfactory accuracy and precision, as long as there
was no previous physical exercise or effect of the menstrual cycle. The diagnostic
accuracy of postprandial hypertriglyceridemia for cardiovascular disease was
suboptimal, but its assessment was conducted without standardized meals. In addition,
the 4-hour test was judged satisfactory and no adequate data were found to support the
choice of one type of triglyceride measure against the other. Finally, in patients with
intermediate fasting triglyceride concentrations there was greater fluctuation of
postprandial triglycerides and thus possibly greater potential for predictive power.
Conclusively, according to the qualitative composition of the data found, postprandial
hypertriglyceridemia appears to be associated with cardiovascular disease but has less
predictive power in patients with T2DM. The meals and conditions for measuring
postprandial methods lipemia are constantly evolving and have predominantly produced
satisfactory results.
Main subject category:
Health Sciences
Keywords:
Postprandial, Lipemia, Lipaemia, Hypertriglyceridemia, Diabetes
File:
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DrBampalisFinal.pdf
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