Fat Tolerance Test - Interpretation Treatment
A positive Fat Tolerance Test shows in vivo the postprandial inability of the body to metabolize fat.
The defective postprandial metabolism of the fat and the presence of elevated plasma triglyceride levels can be diagnosed by performing the Fat Tolerance Test. When the postprandial triglyceride levels are elevated the following changes happen:
1. Formation of the more atherogenic small dense LDL by loading LDL with triglycerides.
2. Formation of small dense HDL, which is not as functional as normal HDL, by loading HDL with triglycerides.
3. Increased plasma triglycerides remnants, which have atherogenic action as well.
All these changes promote atherosclerosis.
Knowing what happens in the vessels, after each fatty meal, is very important because the elevated postprandial triglyceride levels, over time, are associated with the formation of atherosclerotic plaques and the increased risk for cardiovascular events.
This morbid postprandial increase of triglyceride levels cannot be determined after morning blood sampling and triglyceride level determination. The postprandial increase of triglyceride level can be diagnosed ONLY by performing Fat Tolerance Test.
If the Fat Tolerance Test is positive, in the presence of additional risk factors, the patient should start medications to reduce the postprandial lipaemia: omega 3 (n-3) fatty acids 2-4 g/d with or without fibrate alone or in combination with statin.
Important note: The amount of fat, carbohydrates and proteins that should contain the meal and the determination interval of postprandial triglyceride levels are defined by 113 studies performed in the last 2 decades. If the meal of Fat Tolerance Test has not the exact composition, it does not have any diagnostic value.