Which fasting triglyceride levels best reflect coronary risk? evidence from the turkish adult risk factor study
- 1 January 2001
- journal article
- Published by Wiley in Clinical Cardiology
- Vol. 24 (1), 9-14
- https://doi.org/10.1002/clc.4960240103
Abstract
Background: Association between raised low‐density lipoprotein cholesterol (LDL‐C) levels and high risk for coronary heart disease (CHD) is well established and taken into account in guidelines on coronary prevention. Hypothesis: The relationship between risk for coronary heart disease (CHD) and the levels of fasting plasma triglycerides was studied in the cohort of the Turkish Adult Risk Factor Study, a representative random sample of an adult population. Methods: In 829 men and 907 women aged ≥ 27 years (mean 48.5 ± 11), plasma lipids and lipoproteins were measured by the enzymatic dry method in the postabsorptive state. A sample of values was validated in a reference laboratory. Apoliprotein (apo) A‐I and B were measured by the turbidimetric immunoassay using commercial kits in part of the cohort. Blood pressure and anthropometric measurements were made. Criteria for the diagnosis of CHD were based on history, cardiovascular examination, and Minnesota coding of resting electrocardiograms.Coronary heart disease was diagnosed in about 7% of the subjects. Participants were divided into four categories depending on their triglyceride levels: I = < 100 mg/dl (282 men, 400 women), II = 100–139 mg/dl (204 men, 228 women), III = 140–212 mg/dl (188 men, 180 women), and IV = ≥ 212 mg/dl (155 men, 99 women). Results: After adjustment for age, high‐density lipoprotein (HDL) and low‐density lipoprotein (LDL) cholesterol, smoking, and body mass index by logistic regression analysis, and after assigning the CHD risk of 1 to Category I, the relative risk for men and women combined rose to 1.42 in Category III (p<0.045) while it diminished to 0.94 in Category IV (p = 0.79). In women, the odds ratio (OR) rose gradually up to 1.78 (p < 0.025) in Category III, only to decline in Category IV. The OR in men was slightly, insignificantly, and equally elevated in Categories III and IV. Patients with CHD in Category III were not distinguished from those in Category IV by the studied risk parameters. It was suggested that high risk for CHD—particularly in subjects with slightly elevated or normal cholesterol levels—is often not reflected by extreme increases of fasting triglycerides but best by modest elevations (140–212 mg/dl), which serve better as a marker of triglyceride‐rich lipoprotein particles. This knowledge may prove to be of value in population screening and individual risk assessment.Keywords
This publication has 23 references indexed in Scilit:
- Relatively high coronary death and event rates in Turkish women: Relation to three major risk factors in five-year follow-up of cohortInternational Journal of Cardiology, 1997
- Lipoprotein Subclasses in the Monitored Atherosclerosis Regression Study (MARS)Arteriosclerosis, Thrombosis, and Vascular Biology, 1996
- Relative risk of factors for coronary heart disease in population with low cholesterol levelsInternational Journal of Cardiology, 1994
- Effects of Gemfibrozil on Low-Density Lipoprotein Particle Size, Density Distribution, and Composition in Patients With Type II DiabetesDiabetes Care, 1993
- Plasma lipids and their interrelationship in Turkish adults.Journal of Epidemiology and Community Health, 1992
- Lipoprotein cholesterol, apolipoprotein A-I and B and lipoprotein (a) abnormalities in men with premature coronary artery diseaseJournal of the American College of Cardiology, 1992
- Low density lipoprotein particle size and coronary artery disease.Arteriosclerosis and Thrombosis: A Journal of Vascular Biology, 1992
- Intermediate density lipoprotein levels are strong predictors of the extent of aortic atherosclerosis in the St. Thomas's Hospital rabbit strainAtherosclerosis, 1991
- Low density lipoprotein subfractions and relationship to other risk factors for coronary artery disease in healthy individuals.Arteriosclerosis: An Official Journal of the American Heart Association, Inc., 1989
- Plasma tissue plasminogen activator inhibitor levels in coronary artery disease: Correlation with age and serum triglyceride concentrationsJournal of the American College of Cardiology, 1987