Hypertriglyceridemic Waist: A Simple Marker of High‐Risk Atherosclerosis Features Associated With Excess Visceral Adiposity/Ectopic Fat
Open accessAbstract
Background: Subclinical atherosclerosis identification remains challenging; abdominal visceral adiposity may improve risk stratification beyond traditional cardiovascular risk factors. Hypertriglyceridemic waist, a visceral adiposity marker combining elevated triglycerides (≥2 mmol/L) and waist circumference (≥90 cm), has been related to carotid atherosclerosis, although associations with high‐risk features, including lipid‐rich necrotic core (LRNC), remain unknown. We tested the hypothesis that hypertriglyceridemic waist is an independent marker of high‐risk atherosclerosis features. Methods and Results: In this cross‐sectional study including 467 white men (mean age, 45.9±14.8 years; range 19.4–77.6 years), carotid atherosclerosis characteristics were examined by magnetic resonance imaging and associations with hypertriglyceridemic waist and benefits beyond Framingham Risk Score (FRS) and Pathobiological Determinants of Atherosclerosis in Youth (PDAY) were determined. Subclinical carotid atherosclerosis was present in 61.9% of participants, whereas 50.1% had LRNC. Hypertriglyceridemic waist was associated with carotid maximum wall thickness ( P =0.014), wall volume ( P =0.025), normalized wall index ( P =0.004), and Carotid Atherosclerosis Score (derived from wall thickness and LRNC; P =0.049). Hypertriglyceridemic waist was associated with carotid LRNC volume beyond FRS ( P =0.037) or PDAY ( P =0.015), contrary to waist circumference alone (both P >0.05). Although 69.7% and 62.0% of participants with carotid atherosclerosis and/or LRNC were not high‐risk by FRS or PDAY, respectively, hypertriglyceridemic waist correctly reclassified 9.7% and 4.5% of them, respectively. Combining hypertriglyceridemic waist with FRS (net reclassification improvement=0.17; P <0.001) or PDAY (net reclassification improvement=0.05; P =0.003) was superior to each score alone in identifying individuals with carotid atherosclerosis and/or LRNC. Conclusions: Hypertriglyceridemic waist is an independent marker of carotid high‐risk atherosclerosis features in men, improving on FRS and PDAY risk score.
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Early MRI studies have linked hypertriglyceridemia with increased lipid burden in carotid and coronary plaques.
“While primarily research-focused, early MRI studies have linked HTG with increased lipid burden in carotid and coronary plaques [40].”
From Targeting Triglycerides in Cardiovascular Disease Prevention: Evidence, Mechanisms, and Emerging Therapies (2026) · cites this paper as [40]
The Results (Carotid Atherosclerosis Features; page not provided) report greater MRI-measured lipid-rich necrotic core volume in carotid plaques among men with the hypertriglyceridemic waist phenotype. The paper does not establish the same link for hypertriglyceridemia alone or report increased lipid burden in coronary plaques; its coronary-artery measure is a risk score, not coronary plaque lipid imaging. (LLM, conf=0.90)
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POR DENTRO DAS GALHAS: JOGOS DIDÁTICOS COMO FERRAMENTA DE ENSINO E APRENDIZAGEM
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- Authors
- LeBlanc, S., Coulombe, F., Bertrand, O. F., Bibeau, K., Pibarot, P., Marette, A., Alméras, N., Lemieux, I., Després, J., & Larose, E.
- Affiliations
- Institut universitaire de cardiologie et de pneumologie de Québec (CA)
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec City, Québec, Canada
- ORCID
- Venue
- Journal of the American Heart Association
- Published
- 2018-04-17
- Volume
- 7
- Issue
- 8
- ISSN
- 2047-9980 (ISSN-L)
- PMC
- PMC6015425
- OpenAlex
- W2797390801
- Cited by
- 35
- References
- 56
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 3 · 2023: 3 · 2022: 7 · 2021: 7 · 2020: 5 · 2019: 3 · 2018: 2
- FWCI
- 3.38
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- Journal of the American Heart Association (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- Canadian Institutes of Health Research
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Keywords
- visceral fat, ectopic fat, carotid atherosclerosis, lipid-rich necrotic core, subclinical atherosclerosis, triglycerides, waist circumference, cardiovascular risk stratification, Framingham risk score, carotid wall thickness, risk reclassification, men
- MeSH terms
- Adult, Aged, Cross-Sectional Studies, Female, Follow-Up Studies, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Quebec, Retrospective Studies, Risk Factors, Biomarkers, Incidence, Risk Assessment, Intra-Abdominal Fat, Adiposity, Atherosclerosis, Young Adult, Obesity, Abdominal, Hypertriglyceridemic Waist
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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