Associations of hypertriglyceridemia onset age with cardiovascular disease and all-cause mortality in adults: a cohort study
Open accessAbstract
Background: Limited studies have involved new‐onset hypertriglyceridemia, and this study was to evaluate the associations of hypertriglyceridemia onset age with cardiovascular diseases (CVD) and all‐cause mortality. Methods and Results: This population‐based prospective study enrolled 98 779 participants free of hypertriglyceridemia and CVD at baseline in the Kailuan study initiated in June 2006. All participants underwent health checkups biennially until December 2017, and a total of 13 832 participants developed new hypertriglyceridemia. A 1:1 age‐ (±1 year) and sex‐matched analysis was applied to select control subject of the same year for each new‐onset case. There were 13 056 case‐control pairs included. The total follow‐up time was 179 409 person‐years, with a median follow‐up time of 7.0 years. Primary outcomes were CVD and all‐cause mortality, and hazard ratios were estimated after adjustment for baseline characteristics. A total of 807 incident CVD events and 600 all‐cause mortality events were documented. After multivariable adjustment, participants with hypertriglyceridemia onset age <45 years had the highest risk compared with matched controls, with hazard ratios of 2.61 (95% CI, 1.59–4.27) for CVD, 4.69 (95% CI, 2.34–9.40) for all‐cause mortality, 2.23 (95% CI, 0.67–7.38) for myocardial infarction, and 2.68 (95% CI, 1.56–4.62) for stroke. The risk estimates gradually decreased with each decade increase in the onset age of hypertriglyceridemia. Conclusions: Among Chinese adults, hypertriglyceridemia identified at an earlier onset age was associated with higher risks for CVD and all‐cause mortality.
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Hypertriglyceridemia and mixed dyslipidemia are highly prevalent among individuals with metabolic syndrome, type 2 diabetes, obesity, and nonalcoholic fatty liver disease.
“Hypertriglyceridemia (HTG) and mixed dyslipidemia are highly prevalent among individuals with metabolic syndrome, type 2 diabetes, obesity, and nonalcoholic fatty liver disease, and are recognized risk factors for atherosclerotic cardiovascular disease (ASCVD), nonalcoholic steatohepatitis, and acute pancreatitis (Gaudet et al., 2024; Zhou et al., 2022; Kessler et al., 2025; Nawaz et al., 2015).”
From Efficacy and safety of small interfering RNA (siRNA) therapies for hypertriglyceridemia and mixed dyslipidemia: an updated systematic review and meta-analysis (2026) · cites this paper as Zhou et al., 2022
The Methods (Assessment of Covariates; page unavailable) include elevated triglycerides in the definition of metabolic syndrome, and the Discussion (page unavailable) identifies obesity as a risk factor for hypertriglyceridemia. The paper does not establish that hypertriglyceridemia is highly prevalent across all four listed conditions, or address the prevalence of mixed dyslipidemia or specifically nonalcoholic fatty liver disease. (LLM, conf=0.76)
Experimental — accuracy not yet measuredHypertriglyceridemia and mixed dyslipidemia are recognized risk factors for atherosclerotic cardiovascular disease, nonalcoholic steatohepatitis, and acute pancreatitis.
“Hypertriglyceridemia (HTG) and mixed dyslipidemia are highly prevalent among individuals with metabolic syndrome, type 2 diabetes, obesity, and nonalcoholic fatty liver disease, and are recognized risk factors for atherosclerotic cardiovascular disease (ASCVD), nonalcoholic steatohepatitis, and acute pancreatitis (Gaudet et al., 2024; Zhou et al., 2022; Kessler et al., 2025; Nawaz et al., 2015).”
From Efficacy and safety of small interfering RNA (siRNA) therapies for hypertriglyceridemia and mixed dyslipidemia: an updated systematic review and meta-analysis (2026) · cites this paper as Zhou et al., 2022
The Discussion (page not supplied) links hypertriglyceridemia to atherosclerosis and increased cardiovascular disease risk. The paper does not establish the broader claim that both hypertriglyceridemia and mixed dyslipidemia are risk factors for nonalcoholic steatohepatitis or acute pancreatitis; pancreatitis appears as a baseline condition in the Methods and Results, not an outcome of that risk analysis. (LLM, conf=0.88)
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- Authors
- Zhou, H., Ding, X., Yang, Q., Chen, S., Li, Y., Zhou, X., & Wu, S.
- Affiliations
- Central South University (CN)
- Wuhan University (CN)
- Tianjin Medical University General Hospital (CN)
- Kailuan General Hospital (CN)
- North China University of Science and Technology (CN)
- Corresponding author
- Zhou, Hui
- Ding, Xiong
- Yang, Qing
- Zhou, Xin
- Wu, Shouling
- Venue
- Journal of the American Heart Association
- Published
- 2022-10-18
- Volume
- 11
- Issue
- 20
- Pages
- e026632-e026632
- ISSN
- 2047-9980 (ISSN-L)
- PMC
- PMC9673659
- OpenAlex
- W4306406588
- Cited by
- 25
- References
- 47
- Citations by year
- 2026: 8 · 2025: 6 · 2024: 6 · 2023: 5
- FWCI
- 4.06
- 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)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- hypertriglyceridemia, age of onset, cardiovascular disease, all-cause mortality, myocardial infarction, stroke, Chinese adults, Kailuan Study
- MeSH terms
- Adult, Cardiovascular Diseases, Humans, Middle Aged, Mortality, Prospective Studies, Risk Factors, Hypertriglyceridemia, Cohort Studies, Age of Onset
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