Objectives Heterozygous familial hypercholesterolaemia (hFH) is a genetic disease that leads to premature atherosclerosis. Natural menopause leads to an adverse lipid profile resulting in an enhanced risk of coronary heart disease (CHD). Elevated plasma triglycerides also contribute to the risk of vascular events. We evaluated the postprandial triglyceride levels (after a standardised fatty meal) in premenopausal (PreM) and postmenopausal (PostM) women with hFH.

Methods Sixty Greek hFH women were divided into: the PreM group (n  =  30, mean age 33 years (SD 8), mean total cholesterol 351 mg/dl (69)) and the PostM group (n  =  30, mean age 57 years (SD 6), mean total cholesterol 356 mg/dl (74)). Plasma triglyceride concentrations were measured before and 2, 4, 6 and 8 h after a standardised fat load. A value of greater than 220 mg/dl was taken as an abnormal response to the fat load according to our previous studies.

Results PostM women had higher triglyceride levels at 2 (p = 0.02), 4 (p = 0.02), 6 (p = 0.05) and 8 h (p = 0.02) after the fatty meal compared with PreM women. 50% of PostM hFH women versus 20% of PreM hFH women, had abnormal triglyceride responses after a fatty meal. PostM hFH women with an abnormal triglyceride response had higher fasting triglyceride levels (145 vs 74) compared with PostM hFH women with a normal response to fatty meals (p = 0.001).

Conclusions Women with hFH tend to have an abnormal triglyceride response to a fatty meal after the menopause. Fasting triglyceride levels may be able to predict the abnormal response to a fatty meal.