Remnant-like particle cholesterol and triglyceride levels of hypertriglyceridemic patients in the fed and fasted state

Potentially atherogenic triglyceride-rich lipoprotein (TRL) remnants can be isolated and quantitated as remnant-like particles (RLP), using an immunoaffinity gel containing specific anti-human apolipoprotein A-I (apoA-I) and apoB-100 monoclonal antibodies. The aim of the present study was to determine the relationship between postprandial changes in RLP levels and changes in total serum triglyceride (TG) in patients with different forms of hypertriglyceridemia (HTG). Three groups of patients were selected, having similarly elevated serum TG levels: a) HTG with TRL remnant accumulation (i.e., type III patients, n = 15, TG: 3.8 ± 0.2 mM), b) HTG with increased LDL (i.e., type IIb patients, n = 15, TG: 3.7 ± 0.2 mm), and c) HTG without evidence of remnant or LDL accumulation (i.e., type IV patients, n = 15, TG: 3.9 ± 0.3 mm). Ingestion of a 45-g fat meal caused a significant increase in serum TG (30–50%) in all patients. Mean serum TG levels of the three groups were not significantly different at 4 or 6 h after the meal. RLP cholesterol (C) and TG levels increased after the meal in all patients, but these postprandial increases were also not significantly different among groups. Type III patients had significantly higher (P < 0.01) levels of RLP-C and RLP-apoE in the fasted and fed state, and also had significantly higher RLP-C-to-serum TG ratios (P < 0.001) compared with the other groups. These results indicate that 1) RLP-C and RLP-TG levels are significantly increased in the fed versus fasted state in patients with elevated fasting TG levels; 2) patients with different forms of HTG, but similar TG levels, have similar postprandial increases in RLP-C and RLP-TG; and 3) type III patients have significantly elevated levels of RLP-C and RLP-apoE in both the fed and fasted state. —Marcoux, C., P. N. Hopkins, T. Wang, E. T. Leary, K. Nakajima, J. Davignon, and J. S. Cohn. Remnant-like particle cholesterol and triglyceride levels of hypertriglyceridemic patients in the fed and fasted state. J. Lipid Res. 2000. 41: 1428–1436. Potentially atherogenic triglyceride-rich lipoprotein (TRL) remnants can be isolated and quantitated as remnant-like particles (RLP), using an immunoaffinity gel containing specific anti-human apolipoprotein A-I (apoA-I) and apoB-100 monoclonal antibodies. The aim of the present study was to determine the relationship between postprandial changes in RLP levels and changes in total serum triglyceride (TG) in patients with different forms of hypertriglyceridemia (HTG). Three groups of patients were selected, having similarly elevated serum TG levels: a) HTG with TRL remnant accumulation (i.e., type III patients, n = 15, TG: 3.8 ± 0.2 mM), b) HTG with increased LDL (i.e., type IIb patients, n = 15, TG: 3.7 ± 0.2 mm), and c) HTG without evidence of remnant or LDL accumulation (i.e., type IV patients, n = 15, TG: 3.9 ± 0.3 mm). Ingestion of a 45-g fat meal caused a significant increase in serum TG (30–50%) in all patients. Mean serum TG levels of the three groups were not significantly different at 4 or 6 h after the meal. RLP cholesterol (C) and TG levels increased after the meal in all patients, but these postprandial increases were also not significantly different among groups. Type III patients had significantly higher (P < 0.01) levels of RLP-C and RLP-apoE in the fasted and fed state, and also had significantly higher RLP-C-to-serum TG ratios (P < 0.001) compared with the other groups. These results indicate that 1) RLP-C and RLP-TG levels are significantly increased in the fed versus fasted state in patients with elevated fasting TG levels; 2) patients with different forms of HTG, but similar TG levels, have similar postprandial increases in RLP-C and RLP-TG; and 3) type III patients have significantly elevated levels of RLP-C and RLP-apoE in both the fed and fasted state. —Marcoux, C., P. N. Hopkins, T. Wang, E. T. Leary, K. Nakajima, J. Davignon, and J. S. Cohn. Remnant-like particle cholesterol and triglyceride levels of hypertriglyceridemic patients in the fed and fasted state. J. Lipid Res. 2000. 41: 1428–1436. The accurate detection and quantification of potentially atherogenic triglyceride-rich lipoprotein (TRL) remnants has proven to be difficult, because these lipoproteins are cleared rapidly from the blood circulation and are subsequently found at relatively low plasma concentrations. In addition, no single biochemical method can adequately identify and/or separate all remnant lipoproteins, because of their heterogeneity in size, density, and composition (1Cohn J.S. Marcoux C. Davignon J. Detection, quantification and characterization of potentially atherogenic triglyceride-rich remnant lipoproteins.Arterioscler. Thromb. Vasc. Biol. 1999; 19: 2474-2486Google Scholar). A more quantitative and clinically applicable assay has been developed, whereby remnant-like particles (RLP) are separated from plasma using an immunoaffinity gel containing an anti-human apolipoprotein A-I (apoA-I) antibody together with a specific apoB-100 monoclonal antibody (JI-H) (2Nakajima K. Saito T. Tamura A. Suzuki M. Nakano T. Adachi M. Tanaka A. Tada N. Nakamura H. Campos E. Havel R.J. Cholesterol in remnant-like lipoproteins in human serum using monoclonal anti apo B-100 and anti apo A-I immunoaffinity mixed gels.Clin. Chim. Acta. 1993; 223: 53-71Google Scholar, 3Leary E.T. Wang T. Baker D.J. Cilla D.D. Zhong J. Warnick G.R. Nakajima K. Havel R.J. Evaluation of an immunoseparation method for quantitative measurement of remnant-like particle-cholesterol in serum and plasma.Clin. Chem. 1998; 44: 2490-2498Google Scholar). Patients with coronary artery disease (CAD) have significantly increased plasma concentrations of RLP cholesterol (RLP-C) (2Nakajima K. Saito T. Tamura A. Suzuki M. Nakano T. Adachi M. Tanaka A. Tada N. Nakamura H. Campos E. Havel R.J. Cholesterol in remnant-like lipoproteins in human serum using monoclonal anti apo B-100 and anti apo A-I immunoaffinity mixed gels.Clin. Chim. Acta. 1993; 223: 53-71Google Scholar, 3Leary E.T. Wang T. Baker D.J. Cilla D.D. Zhong J. Warnick G.R. Nakajima K. Havel R.J. Evaluation of an immunoseparation method for quantitative measurement of remnant-like particle-cholesterol in serum and plasma.Clin. Chem. 1998; 44: 2490-2498Google Scholar, 4Devaraj S. Vega G. Lange R. Grundy S.M. Jialal I. Remnant-like particle cholesterol levels in patients with dysbeta-lipoproteinemia or coronary artery disease.Am. J. Med. 1998; 104: 445-450Google Scholar). Elevated RLP levels are in turn associated with impaired endothelium-dependent vasorelaxation (5Doi H. Kugiyama K. Ohgushi M. Sugiyama S. Matsumura T. Ohta Y. Nakano T. Nakajima K. Yasue H. Remnants of chylomicron and very low density lipoprotein impair endothelium-dependent vasorelaxation.Atherosclerosis. 1998; 37: 341-349Google Scholar, 6Kugiyama K. Doi H. Motoyama T. Soejima H. Misumi K. Kawano H. Nakagawa O. Yoshimura M. Ogawa H. Matsumura T. Sugiyama S. Nakano T. Nakajima K. Yasue H. Association of remnant lipoprotein levels with impairment of endothelium-dependent vasomotor function in human coronary arteries.Circulation. 1998; 97: 2519-2526Google Scholar) and are predictive of future coronary events in patients with CAD (7Kugiyama K. Doi H. Takazoe K. Kawano H. Soejima H. Mizuno Y. Tsunoda R. Sakamoto T. Nakano T. Nakajima K. Ogawa H. Sugiyama S. Yoshimura M. Yasue H. Remnant lipoprotein levels in fasting serum predict coronary eventsin patients with coronary artery disease.Circulation. 1999; 99: 2858-2860Google Scholar). In the fasted state, a strong positive correlation exists between RLP-C and total plasma triglyceride (TG) concentrations (2Nakajima K. Saito T. Tamura A. Suzuki M. Nakano T. Adachi M. Tanaka A. Tada N. Nakamura H. Campos E. Havel R.J. Cholesterol in remnant-like lipoproteins in human serum using monoclonal anti apo B-100 and anti apo A-I immunoaffinity mixed gels.Clin. Chim. Acta. 1993; 223: 53-71Google Scholar, 3Leary E.T. Wang T. Baker D.J. Cilla D.D. Zhong J. Warnick G.R. Nakajima K. Havel R.J. Evaluation of an immunoseparation method for quantitative measurement of remnant-like particle-cholesterol in serum and plasma.Clin. Chem. 1998; 44: 2490-2498Google Scholar, 8McNamara J.R. Shah P.K. Nakajima K. Cupples L.A. Wilson P.W.F. Ordovas J.M. Schaefer E.J. Remnant lipoprotein cholesterol and triglyceride reference ranges from the Framingham Heart Study.Clin. Chem. 1998; 44: 1224-1232Google Scholar), and patients with hypertriglyceridemia (HTG) invariably have increased fasting levels of RLP (9Marcoux C. Tremblay M. Fredenrich A. Jacques H. Krimbou L. Nakajima K. Davignon J. J.S. remnant-like particle and apolipoprotein levels in and 1998; Scholar). HTG patients with type III have a increase in remnant lipoproteins (i.e., very low density Type III the of apolipoprotein in and lipoprotein The of Scholar), have significantly increased fasting RLP levels K. Saito T. Tamura A. Suzuki M. Nakano T. Adachi M. Tanaka A. Tada N. Nakamura H. T. A for the detection of type III Thromb. Scholar, C. Tremblay M. Nakajima K. Davignon J. J.S. of remnant-like particles isolated immunoaffinity gel from the plasma of type III and type IV Lipid Res. 1999; Scholar) and their ratios of RLP-C to plasma TG are significantly of patients with other forms of HTG C. Tremblay M. Nakajima K. Davignon J. J.S. of remnant-like particles isolated immunoaffinity gel from the plasma of type III and type IV Lipid Res. 1999; Scholar, T. Nakajima K. E.T. Warnick G.R. J.S. Cilla D.D. Zhong J. Havel R.J. of remnant-like particle-cholesterol to serum total an to and in the of type III Chem. 1999; Scholar). In all these plasma RLP levels have been in plasma or serum after an and plasma RLP concentrations in the fed state. patients with different forms of HTG have similar postprandial changes in The aim of the present study was to the relationship between postprandial changes in RLP levels and changes in total serum TG in patients with different forms of Three groups of HTG patients have been were that had similarly elevated fasting TG levels: a) HTG with fasting plasma TRL remnant accumulation (i.e., type III b) HTG with increased fasting levels of LDL type IIb and c) HTG without evidence of fasting remnant or LDL accumulation (i.e., type IV HTG patients were from the Lipid of the of or the of the of at the of in The study was and all patients their to or patients were of or and had a of Patients were had not been for at 6 the were had had a coronary artery or the 6 A total of patients were the meal. Patients were for the present had a fasting plasma TG between and the of the A total of patients were as having a) type III had an and the of gel 2) type IIb had an LDL cholesterol and no evidence of or 3) type IV had an LDL cholesterol and no evidence of patients were from total of in a that the three groups had similar and TG a patients were a of with and of and of The total fat of the meal was blood were in the fasted state the meal at and in the fed state and h was and was to for at were at for to at to separate serum from from both study were to and were to for and lipoprotein and for and of RLP from patients in were also at at the of for of RLP RLP were isolated from serum with RLP cholesterol assay to the of serum was to of gel containing antibodies. for h at with a the gel was to for and the containing the was for cholesterol and triglyceride a The of for the measurement of RLP cholesterol was and for a low and the was and E.T. Wang T. Baker D.J. Cilla D.D. Zhong J. Warnick G.R. Nakajima K. Havel R.J. Evaluation of an immunoseparation method for quantitative measurement of remnant-like particle-cholesterol in serum and plasma.Clin. Chem. 1998; 44: 2490-2498Google Scholar). serum cholesterol and triglyceride concentrations were for fasted cholesterol was after of lipoproteins < and lipoproteins were separated in a for 4 E.T. Wang T. Baker D.J. Cilla D.D. Zhong J. Warnick G.R. Nakajima K. Havel R.J. Evaluation of an immunoseparation method for quantitative measurement of remnant-like particle-cholesterol in serum and plasma.Clin. Chem. 1998; 44: 2490-2498Google Scholar). LDL cholesterol was as the between cholesterol in the and The of in the < was gel was gel of serum J.S. of apolipoprotein to Chem. Scholar) or a method of human apolipoprotein and with Lipid Res. Scholar). and were in serum and were in RLP assay J.S. Tremblay M. M. M. J. Davignon J. of apolipoprotein in remnant-like lipoproteins in and Thromb. Vasc. Biol. Scholar, A. Tremblay M. Krimbou L. Davignon J. J.S. lipoprotein of in and hypertriglyceridemic of the to in different lipoprotein Lipid Res. Scholar). were with was for the of between groups. were were not were to and of were to at different the meal. The of the three HTG groups are in were and 6 in the type IIb and in the type III and and 4 in the type IV The of patients in the type IIb was n = and and in the type IV was n = and to all patients in the type III had an and total fasting serum TG concentrations of the three study groups were similar Mean cholesterol concentrations were also Type IIb patients had significantly higher serum levels of LDL and significantly elevated total serum cholesterol and concentrations. The in type III patients was elevated levels of and these patients had increased levels of serum compared with other patients of hypertriglyceridemic IIb = III = IV = ± ± ± ± ± ± ± 0.2 ± ± 0.2 ± ± ± ± 0.3 ± < ± ± ± ± < < ± ± < ± 0.2 ± ± ± < ± 0.3 ± < ± 0.2 ± ± ± < ± ± ± ± ± ± ± ± < ± ± ± ± < < ± ± < ± ± ± ± ± ± < ± 0.2 ± ± ± < < ± levels are in and plasma are in and in different from type III patients or were not < < < in a ± levels are in and plasma are in and in different from type III patients or were not Ingestion of the meal in a significant increase (P < 0.01) in serum triglyceride (30–50%) in all patients increase in serum triglyceride to be in type III patients, no significant was found between postprandial triglyceride levels of different groups at or h after the meal. In all three serum TG levels in the fed state were with their in the fasted correlation between and 4 h TG levels were (P < (P < and (P < and between and 6 h TG levels were (P < (P < and (P < 0.001) for type and IV patients, Mean serum RLP-C and RLP-TG levels in the fasted and fed state and are for the three groups in In the fasted state, type III patients had significantly higher RLP-C levels ± ± and ± type III IIb and < also had significantly higher RLP-TG levels (P < 0.001) compared with type IIb patients, but not compared with type IV patients ± ± and ± type III IIb and RLP-C levels were significantly with fasting TG levels: = (P < (P < and (P < 0.001) for type and IV patients, RLP-TG levels were also significantly with fasting TG levels: = (P < (P < and (P < 0.001) for type and IV patients, Ingestion of the meal caused RLP-C and RLP-TG concentrations to and levels at 4 and 6 h after the meal were significantly higher fasting levels in all groups (P < but not RLP-TG were significantly higher in type III patients in the fed state RLP-C levels were significantly with fasting and postprandial RLP-TG levels were significantly with fasting between fasting and RLP-C levels were = (P < = (P < and = (P < 0.01) for type and IV patients, and between fasting and RLP-TG levels were = (P < = (P < and = (P < increase in levels of serum and RLP-TG were fasting concentrations from at and h after the meal. Mean for the three groups are compared in Type III patients to have and type IV patients to have postprandial increases in all three no significant were found between at postprandial all three had to fasting levels in type IIb and type III patients, not as in type IV patients. increase in the of RLP-C was not significantly with fasting serum TG levels (i.e., for at 4 = = not = and = for type and IV patients, increase in the of RLP-C was also not significantly with fasting RLP-C levels (i.e., for at 4 = = = and (P = for type and IV patients, increases in RLP-TG at 4 and 6 h were also not with fasting TG or fasting RLP-TG concentrations. a strong correlation between postprandial increases in RLP-C and postprandial total TG levels (i.e., for at 4 = < < and < for at 6 = < < and < for type and IV patients, strong between postprandial increases in RLP-TG and postprandial increases in total TG levels (i.e., for at 4 = < < and < for at 6 = < < and < for type and IV patients, increase in serum RLP and RLP triglyceride of type IIb patients type III patients and type IV patients significant were found between groups at postprandial changes to be in type III A of the in was the the postprandial in RLP-TG to the other in more of the postprandial increase in serum TG of type IIb and III patients was for an increase in in type IV patients all of the postprandial increase in serum TG was for an increase in RLP-TG increased to a after the meal in a significant (P < 0.01) in the of RLP-C to RLP-TG in all patients The RLP in cholesterol in type III other patients in both the fasted and fed state, as a significantly higher (P < 0.01) of RLP-C to RLP-TG at all in the RLP of hypertriglyceridemic patients in the fasted and fed state and or RLP-C to RLP-TG were significantly in the fed state and 6 compared with the fasted state in all three groups (P < Mean that were significantly different from in type III patients are < < Elevated RLP-C and of the RLP with cholesterol in the fasted state are of patients with type III K. Saito T. Tamura A. Suzuki M. Nakano T. Adachi M. Tanaka A. Tada N. Nakamura H. T. A for the detection of type III Thromb. Scholar, C. Tremblay M. Nakajima K. Davignon J. J.S. of remnant-like particles isolated immunoaffinity gel from the plasma of type III and type IV Lipid Res. 1999; Scholar, T. Nakajima K. E.T. Warnick G.R. J.S. Cilla D.D. Zhong J. Havel R.J. of remnant-like particle-cholesterol to serum total an to and in the of type III Chem. 1999; Scholar). The of RLP-C to total serum or plasma TG in the fasted state has been to type III patients from with other forms of HTG T. Nakajima K. E.T. Warnick G.R. J.S. Cilla D.D. Zhong J. Havel R.J. of remnant-like particle-cholesterol to serum total an to and in the of type III Chem. 1999; Scholar). of has been to be a for type III in was of the type III patients in the fasted state and of the type IIb or IV patients. also type III patients in the fed state, ratios of RLP-C to serum TG were for patients at 4 and 6 h after the meal. Ingestion of the meal not significantly the of RLP-C to TG in type IIb patients ± ± and ± and 6 or of type IV patients ± ± and ± and 6 In ratios in type III patients and was ± ± (P < and ± (P < and 6 of at 4 h and of type III patients at 6 h had a of the type IIb or IV patients had a in the fed state RLP apolipoprotein levels were in a of patients = 6 for and are in The between the type III patients and the was the significantly increased of RLP-apoE among the patients, were elevated to in both the fasted and fed state. RLP-apoE levels not increase after the meal in type III patients, but were significantly elevated fasting levels in type IIb and IV patients at both 4 and 6 h (P < levels were also significantly higher in the fed state, in type IIb and IV patients at 4 h (P < significant in fasted or fed levels were found between groups. levels were not significantly the and to be higher in type III patients in both the fasted and fed state. The present study has that serum RLP-C and RLP-TG levels increase in HTG patients after the of a meal. The of increase in RLP-C and RLP-TG was similar in type and IV patients, had similar levels of fasting the that type III patients had significantly elevated remnant lipoprotein levels in the fasted state the of and also significantly elevated fasting levels of RLP-C compared with type IIb and IV patients, not have an postprandial increase in RLP type IIb patients had significantly elevated levels of LDL in both the fasted and fed state, their postprandial RLP was similar to that of other patients. the and for in these HTG patients were had similar fasting TG levels, a similar of postprandial and similar postprandial increases in RLP These results are with the that of the of postprandial in HTG patients of the of their the fasting triglyceride and/or because of and of are the for a triglyceride for and very low density lipoproteins in Scholar, J.S. J.R. Ordovas J.M. Schaefer E.J. plasma lipoprotein changes in human of different Lipid Res. Scholar, J. A. M. J. L. P. of very low density lipoprotein in plasma of a triglyceride for a Lipid Res. 37: Scholar). the blood circulation after the of a meal are lipoprotein with as the that are for the of in the fasted state. The more the in the fasted state, the the of postprandial triglyceride concentrations are significantly with fasting triglyceride levels, and as have found in the present postprandial RLP concentrations are significantly with fasting RLP have found that patients with type III not postprandial RLP cholesterol or RLP triglyceride to a the other HTG patients. of postprandial of type III and type IV patients has been compared S. of postprandial lipoprotein in type type III and type IV of with and Scholar), that postprandial was not in type III was in type III versus type IV patients. A. of chylomicron remnants in in to the Lipid Res. Scholar) have similarly that the postprandial increase in plasma TG was no in compared with or in and chylomicron remnants of was significantly The present results have also that postprandial of type III patients was not increased compared with that of other HTG patients RLP-TG and RLP-C levels were with total plasma TG levels in both the fasted and fed state, the postprandial increase in RLP was also found not to be in type III patients. the that in all patients a of the postprandial increase in total plasma TG was for an increase in RLP-TG all and chylomicron remnants of to have been isolated the RLP the of be and not be as a the was of of Scholar) to lipoprotein particles that were from particles present in the circulation after of had a of compared with a of for and a of compared with for was that of the triglyceride in had to be in to chylomicron The of a triglyceride-rich lipoprotein remnant was the in of A. J. of apolipoprotein in triglyceride-rich very low density lipoproteins of and hypertriglyceridemic Scholar), that in of was to LDL A significant of was found to be to a particle in the or density and remnant particle was from the remnants have as of TRL or are rapidly from the circulation and are not to density remnant lipoproteins are the biochemical are for density lipoproteins are are and Remnants isolated immunoaffinity gel are remnant-like particles (RLP), their apolipoprotein composition and their immunoaffinity to a specific The present results that in the fed state a significant of both as as These lipoproteins and not apoB-100 and are not the immunoaffinity that the RLP that chylomicron in the has as apolipoprotein of and be a In no remnant and of a TRL to TRL remnants have a remnant and the of these lipoproteins to the of (1Cohn J.S. Marcoux C. Davignon J. Detection, quantification and characterization of potentially atherogenic triglyceride-rich remnant lipoproteins.Arterioscler. Thromb. Vasc. Biol. 1999; 19: 2474-2486Google Scholar). the present study the of RLP levels in HTG patients in the fed state, three have RLP levels after the of an fat H. K. M. H. and coronary artery Scholar, A. N. Y. K. Tamura M. Nakajima K. M. K. I. Remnant-like particles and of coronary after Scholar, A. N. Nakano T. Nakajima K. K. Tamura M. of postprandial remnant-like particles a Chim. Acta. 1998; Scholar). The results of these are in together with the results of the present a was not in the present and from different not that HTG patients to have postprandial increases in RLP-C and RLP-TG levels to In addition, can be that the postprandial increase in RLP levels to be in with CAD H. K. M. H. and coronary artery Scholar) and in CAD patients with A. N. Y. K. Tamura M. Nakajima K. M. K. I. Remnant-like particles and of coronary after Scholar), to the that postprandial lipoproteins and postprandial TRL remnants an in the and of CAD J.R. G. T. E. of triglyceride and coronary artery in the postprandial Thromb. Scholar, J.S. evidence for of remnant J. 1998; of postprandial RLP = of fat = RLP-TG = with CAD = = RLP-TG patients = fat of = patients with = = of = RLP-TG = patients = meal of IIb = = RLP-TG III = = RLP-TG = IV = = RLP-TG coronary artery postprandial fasting triglyceride in a coronary artery postprandial fasting triglyceride In postprandial has been in the of and TRL to postprandial hypertriglyceridemia J.S. Scholar). that the of postprandial increase in TG to the accumulation in plasma of the postprandial increase in TRL to the accumulation in plasma of L. Havel R.J. between the of triglyceride-rich lipoproteins in blood plasma containing apolipoprotein and to a meal in 1993; Scholar, G. T. L.A. A. of triglyceride-rich lipoproteins 1993; Scholar, J.S. E.J. J.S. Schaefer E.J. of and apoB-100 triglyceride-rich lipoproteins (TRL) to postprandial increases in the plasma of TRL and Lipid Res. 1993; Scholar). In of particle can that are a of remnants in the fed state compared with have that in the RLP isolated from after an all In type IV patients, of was in type III patients of was C. Tremblay M. Nakajima K. Davignon J. J.S. of remnant-like particles isolated immunoaffinity gel from the plasma of type III and type IV Lipid Res. 1999; Scholar). from ratios of to apoB-100 in the present measurement of total RLP levels that of the meal not a postprandial increase in total of RLP particles in of the groups levels increase in all patients. that was no postprandial in total have been an increase in with a in to between and TRL for as for a triglyceride for and very low density lipoproteins in Scholar, J.S. J.R. Ordovas J.M. Schaefer E.J. plasma lipoprotein changes in human of different Lipid Res. Scholar, J. A. M. J. L. P. of very low density lipoprotein in plasma of a triglyceride for a Lipid Res. 37: Scholar). of the of the present the that type III patients had increased levels of RLP-C and RLP-apoE in both the fasted and fed state compared with patients with other forms of was that the of remnant lipoprotein and plasma accumulation in type III patients the impaired of TRL to Type III the of apolipoprotein in and lipoprotein The of RLP-C levels are elevated to a in the fasted state in type III patients that their of RLP-C to TG can be to from HTG patients with other forms of T. Nakajima K. E.T. Warnick G.R. J.S. Cilla D.D. Zhong J. Havel R.J. of remnant-like particle-cholesterol to serum total an to and in the of type III Chem. 1999; Scholar). The present results that also for type III patients in the fed state, that the of RLP-C to TG a for type III using or fasted serum In the present results have 1) RLP-C and RLP-TG levels are significantly increased in the fed versus fasted state in HTG 2) patients with different forms of HTG, but similar TG levels, have similar postprandial increases in RLP-C and RLP-TG; and 3) compared with patients with other forms of HTG, type III patients have significantly elevated levels of RLP-C and RLP-apoE in both the fasted and fed state.