Association of Post Prandial Hyper Triglyceridemia and Carotid Intima Media Thickness in Patients with Type-2 Diabetes Mellitus

Aim: To investigate the role of postprandial triglyceride levels and its relation with carotid intima media thickness in patients with type 2 diabetes mellitus. Methods: This is a case-control study which comprises 50 patients of age between 40 and 60 years with type 2 diabetes mellitus of more than or equal to 3 years duration. Carotid artery Doppler was done by B-mode ultrasonography using a 7.5MHz transducer. Blood samples were obtained after an overnight fast (12 hours) for total cholesterol, Fasting triglyceride, HDL, LDL, VLDL levels, which are measured by standard laboratory technique. Then patients ate a standard meal that had a total energy of 9 Kcal/Kg with 60-65% of this energy being supplied by carbohydrate, 15-20% by protein and 20% by fat after taking insulin or oral hypoglycemic agent. Blood samples were taken again 4 hours after the meal for postprandial triglyceride level. Results: Patients were divided into three groups. The first group normo-normo (NN) group i.e patients having normal fasting and postprandial triglyceride levels. Second group is normo-hyper (NH) group i.e patients having normal fasting but high postprandial triglyceride levels. Third group is hyper-hyper (HH) group i.e patients with high fasting and high postprandial triglyceride levels. Carotid intima media thickness was significantly higher in both the NH (1.78±0.81mm) and HH group (2.06±0.08mm) than the NN group (0.52±0.13mm). The correlation between CIMT and fasting triglyceride, postprandial hypertriglyceride was statistically significant (P<0.001). Conclusions: Postprandial hypertriglyceridemia, despite normal fasting triglyceride levels, may be an independent risk factor for early atherosclerosis in type 2 diabetics. Hence PPTG levels should be monitored in patients with type 2 diabetes.