Postprandial glucose and not triglyceride concentrations are associated with carotid intima media thickness in women with normal glucose metabolism: The Hoorn prandial study


      The present study aimed to compare the associations of postprandial glucose (ppGL) and postprandial triglycerides (ppTG) with carotid intima media thickness (cIMT) in women with normal glucose metabolism (NGM) and type 2 diabetes (DM2).
      Post-menopausal women (76 with NGM, 78 with DM2), received two consecutive fat-rich and two consecutive carbohydrate-rich meals on separate occasions. Blood samples were taken before and 1, 2, 4, 6 and 8 h following breakfast; lunch was given at t = 4. Ultrasound imaging of the carotid artery was performed to measure cIMT.
      In women with NGM, an increase of 1.0 mmol/l glucose following the fat-rich meals was associated with a 50 μm cIMT increase (p = 0.04), and following the carbohydrate meals, an increase of 1.8 mmol/l glucose was associated with a 50 μm larger cIMT (p = 0.08). These associations were not explained by classical cardiovascular risk factors. However, no association between ppGL and cIMT was found in women with DM2 and ppTG were not associated with cIMT.
      The association between ppGL and cIMT in normoglycaemic women suggests that ppGL in the normal range is a marker or a risk factor for atherosclerosis. Postprandial glucose levels might be a better indicator of risk than post-OGTT glucose levels or triglyceride levels.


      CVD (cardiovascular disease), cIMT (carotid intima media thickness), DM2 (type 2 diabetes mellitus), HOMA-IR (homeostasis model assessment), NGM (normal glucose metabolism), ppGL (postprandial glucose), ppTG (postprandial triglycerides)


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Atherosclerosis
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Huxley R.
        • Barzi F.
        • Woodward M.
        Excess risk of fatal coronary heart disease associated with diabetes in men and women: meta-analysis of 37 prospective cohort studies.
        BMJ. 2006; 332: 73-78
        • Yusuf S.
        • Hawken S.
        • Ounpuu S.
        • et al.
        Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case–control study.
        Lancet. 2004; 364: 937-952
        • Turner R.C.
        • Millns H.
        • Neil H.A.
        • et al.
        Risk factors for coronary artery disease in non-insulin dependent diabetes mellitus: United Kingdom Prospective Diabetes Study (UKPDS: 23).
        BMJ. 1998; 316: 823-828
        • Zilversmit D.B.
        Atherogenesis: a postprandial phenomenon.
        Circulation. 1979; 60: 473-485
        • de Vegt F.
        • Dekker J.M.
        • Ruhe H.G.
        • et al.
        Hyperglycaemia is associated with all-cause and cardiovascular mortality in the Hoorn population: the Hoorn Study.
        Diabetologia. 1999; 42: 926-931
        • Hanefeld M.
        • Koehler C.
        • Schaper F.
        • et al.
        Postprandial plasma glucose is an independent risk factor for increased carotid intima-media thickness in non-diabetic individuals.
        Atherosclerosis. 1999; 144: 229-235
      1. DECODE Study Group, et al. Glucose tolerance and cardiovascular mortality: comparison of fasting and 2-hour diagnostic criteria. Arch Intern Med 2001;161(3):397–405.

        • Sharrett A.R.
        • Chambless L.E.
        • Heiss G.
        • Paton C.C.
        • Patsch W.
        Association of postprandial triglyceride and retinyl palmitate responses with asymptomatic carotid artery atherosclerosis in middle-aged men and women. The Atherosclerosis Risk in Communities (ARIC) Study.
        Arterioscler Thromb Vasc Biol. 1995; 15: 2122-2129
        • Karpe F.
        • de Faire U.
        • Mercuri M.
        • et al.
        Magnitude of alimentary lipemia is related to intima-media thickness of the common carotid artery in middle-aged men.
        Atherosclerosis. 1998; 141: 307-314
        • Boquist S.
        • Ruotolo G.
        • Tang R.
        • et al.
        Alimentary lipemia, postprandial triglyceride-rich lipoproteins, and common carotid intima-media thickness in healthy, middle-aged men.
        Circulation. 1999; 100: 723-728
        • Teno S.
        • Uto Y.
        • Nagashima H.
        • et al.
        Association of postprandial hypertriglyceridemia and carotid intima-media thickness in patients with type 2 diabetes.
        Diabetes Care. 2000; 23: 1401-1406
        • Ahmad J.
        • Hameed B.
        • Das G.
        • Siddiqui M.A.
        • Ahmad I.
        Postprandial hypertriglyceridemia and carotid intima-media thickness in north Indian type 2 diabetic subjects.
        Diabetes Res Clin Pract. 2005; 69: 142-150
        • Mari A.
        • Tura A.
        • Gastaldelli A.
        • Ferrannini E.
        Assessing insulin secretion by modeling in multiple-meal tests: role of potentiation.
        Diabetes. 2002; 51: S221-S226
        • Heine R.J.
        • Dekker J.M.
        Beyond postprandial hyperglycaemia: metabolic factors associated with cardiovascular disease.
        Diabetologia. 2002; 45: 461-475
        • Alberti K.G.
        • Zimmet P.Z.
        Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1. Diagnosis and classification of diabetes mellitus provisional report of a WHO consultation.
        Diabet Med. 1998; 15: 539-553
        • Mooy J.M.
        • Grootenhuis P.A.
        • de Vries H.
        • et al.
        Prevalence and determinants of glucose intolerance in a Dutch Caucasian population. The Hoorn Study.
        Diabetes Care. 1995; 18: 1270-1273
        • Wendel-Vos G.C.
        • Schuit A.J.
        • Saris W.H.
        • Kromhout D.
        Reproducibility and relative validity of the short questionnaire to assess health-enhancing physical activity.
        J Clin Epidemiol. 2003; 56: 1163-1169
        • Henry R.M.
        • Kostense P.J.
        • Spijkerman A.M.
        • et al.
        Arterial stiffness increases with deteriorating glucose tolerance status: the Hoorn Study.
        Circulation. 2003; 107: 2089-2095
        • Mohan V.
        • Ravikumar R.
        • Shanthi R.S.
        • Deepa R.
        Intimal medial thickness of the carotid artery in South Indian diabetic and non-diabetic subjects: the Chennai Urban Population Study (CUPS).
        Diabetologia. 2000; 43: 494-499
      2. Voorlichtingsbureau voor de Voeding. NEVO Table Netherlands (Dutch Nutrient Database); 2001.

        • Friedewald W.T.
        • Levy R.I.
        • Fredrickson D.S.
        Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge.
        Clin Chem. 1972; 18: 499-502
        • Matthews D.R.
        • Hosker J.P.
        • Rudenski A.S.
        • et al.
        Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man.
        Diabetologia. 1985; 28: 412-419
        • Temelkova-Kurktschiev T.
        • Henkel E.
        • Schaper F.
        • et al.
        Prevalence and atherosclerosis risk in different types of non-diabetic hyperglycemia. Is mild hyperglycemia an underestimated evil?.
        Exp Clin Endocrinol Diabetes. 2000; 108: 93-99
        • Esposito K.
        • Giugliano D.
        • Nappo F.
        • Marfella R.
        Regression of carotid atherosclerosis by control of postprandial hyperglycemia in type 2 diabetes mellitus.
        Circulation. 2004; 110: 214-219
        • van Beek A.P.
        • Ruijter-Heijstek F.C.
        • Erkelens D.W.
        • de Bruin T.W.
        Menopause is associated with reduced protection from postprandial lipemia.
        Arterioscler Thromb Vasc Biol. 1999; 19: 2737-2741
        • Goldschmid M.G.
        • Barrett-Connor E.
        • Edelstein S.L.
        • et al.
        Dyslipidemia and ischemic heart disease mortality among men and women with diabetes.
        Circulation. 1994; 89: 991-997
        • Kannel W.B.
        • Wilson P.W.
        Risk factors that attenuate the female coronary disease advantage.
        Arch Intern Med. 1995; 155: 57-61
        • Hughes T.A.
        • Elam M.B.
        • Applegate W.B.
        • et al.
        Postprandial lipoprotein responses in hypertriglyceridemic subjects with and without cardiovascular disease.
        Metabolism. 1995; 44: 1082-1098
        • Schaefer E.J.
        • Audelin M.C.
        • McNamara J.R.
        • et al.
        Comparison of fasting and postprandial plasma lipoproteins in subjects with and without coronary heart disease.
        Am J Cardiol. 2001; 88: 1129-1133
        • Karpe F.
        • Boquist S.
        • Tang R.
        • et al.
        Remnant lipoproteins are related to intima-media thickness of the carotid artery independently of LDL cholesterol and plasma triglycerides.
        J Lipid Res. 2001; 42: 17-21
        • Ginsberg H.N.
        • Jones J.
        • Blaner W.S.
        • et al.
        Association of postprandial triglyceride and retinyl palmitate responses with newly diagnosed exercise-induced myocardial ischemia in middle-aged men and women.
        Arterioscler Thromb Vasc Biol. 1995; 15: 1829-1838
        • Ceriello A.
        • Taboga C.
        • Tonutti L.
        • et al.
        Evidence for an independent and cumulative effect of postprandial hypertriglyceridemia and hyperglycemia on endothelial dysfunction and oxidative stress generation: effects of short- and long-term simvastatin treatment.
        Circulation. 2002; 106: 1211-1218
        • Cheng K.S.
        • Mikhailidis D.P.
        • Hamilton G.
        • Seifalian A.M.
        A review of the carotid and femoral intima-media thickness as an indicator of the presence of peripheral vascular disease and cardiovascular risk factors.
        Cardiovasc Res. 2002; 54: 528-538
        • Kozakova M.
        • Ferrannini E.
        • and the RISC Investigators
        Relationship between insulin sensitivity and carotid artery intima-media thickness in healthy subjects: the RISC Study.
        Diabetologia. 2005; 48 ([abstract]): A-222
        • Ando F.
        • Takekuma K.
        • Niino N.
        • Shimokata H.
        Ultrasonic evaluation of common carotid intima-media thickness (IMT)—influence of local plaque on the relationship between IMT and age.
        J Epidemiol. 2000; 10: S10-S17