Background: Enhanced postprandial lipaemia has been reported in patients with obesity,
hypertension, metabolic syndrome and type 2 diabetes mellitus (T2DM). We compared 2 oral fat meal
tests (LIPOLD: 149g of fat, 56g of carbohydrates and 11.7g of proteins administrated per 2m2 of body
surface) and LIPOTEST: 75g of fat, 25g of carbohydrates and 10g of protein with the addition of 15g
common sugar) with regard to changes in triglycerides (TGs) as well as other cardiometabolic parameters
between baseline and 4 h after the meals.
Methods: We studied 21 men [median age (interquartile range; IQR) = 65 (16) years] with wellcontrolled
T2DM [median glycated haemoglobin (HbA1c) (IQR) = 6.6 (0.9) %]. All participants performed
the meals with 1 week interval between the 2 meals.
Results: Median (IQR) TG differences in mg/dl were 86 (100) and 46 (60) for LIPOLD and LIPOTEST
meals, respectively, whereas the % differences in TGs were 105 (105) and 48 (55), respectively. The
differences (in mg/dl and %) between TGs before ingesting the test meal and after 4h were significant
for both LIPOLD and LIPOTEST meals (p = 0.003 for mg/dl differences and p = 0.005 for % differences).
Patients who had a positive response to the LIPOLD meal (i.e. TGs > 220 mg/dl at 4 h) also had
increased postprandial TGs with LIPOTEST. The Homeostasis Model Assessment of Insulin Resistance
(HOMA-IR) correlated with TG differences (in mg/dl) following the LIPOLD meal consumption
(Spearman's rho = (+) 0.527, p = 0.02). C-peptide correlated with TG differences (in mg/dl) following
the LIPOTEST meal consumption (Spearman's rho = (+) 0.538, p = 0.032). There were no differences in
TGs and glucose response postprandially in both testing meals according to body mass index (except for
TGs between tertile 21.3-24.5 and 25-26.8 kg/m2, p=0.046, in LPOTEST group) and body surface area.
Conclusion: An oral fat tolerance test (OFTT), which contains 75g fat, and represents the everyday
habits of Western societies, could provide additional information regarding the postprandial state of the
individuals with well-controlled T2DM. The consumption of meals with very high fat content may lead
to over diagnosing PPL. TG differences after the consumption of a high fat meal correlated with
HOMA-IR. This may be useful to evaluate the role of HOMA-IR in T2DM patients. A standardized the
OFTT will help clinicians to better define postprandial TG abnormalities, leading to more appropriate
therapeutic options to improve postprandial dysmetabolism.