Postprandial lipemia and incretins in endothelial reactivity

Abstract

Obesity is a chronic disease whose prevalence has been increasing considerably, becoming a serious public health problem. Currently, the increase in its prevalence is related to the changes in eating habits, which indicates higher intake of high-fat meals, mainly saturated fat. Moreover, such excessive consumption has happened in shorter intervals between meals and it causes a prolonged state of postprandial lipemia, currently considered one of the main factors for metabolic abnormalities, such as insulin resistance (IR) and cardiovascular disease (CVD). In this process, obese subjects are considered more problematic, because the excessive amount of visceral fat reduces insulin sensitivity and causes hyperinsulinemia, altering the homeostasis of the vascular system, with consequent microvascular and endothelial dysfunction, being the latter a risk factor for the onset of early atherosclerosis and acute events such as acute myocardial infarction (AMI). Recent studies have shown that incretins, specifically the glucagon-like peptide-1 (GLP-1), may exert beneficial effects on the cardiovascular system. It is also suggested that in obesity and type 2 diabetes mellitus, incretins present reduced action, increasing CVD risk and affecting the satiety control. This review aims to clarify the importance of incretins in modulating lipids during postprandial lipemia and its relation to microvascular dysfunction, focusing on studies performed in obese subjects.