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Changes in triglyceride levels and risk for coronary heart disease in young men.
Abstract
BACKGROUND: Current triglyceride levels might be only a weak predictor of risk for coronary heart disease (CHD). OBJECTIVE: To assess the association between changes over time in fasting triglyceride levels and CHD risk in young adults. DESIGN: Follow-up study over 5.5 years after 2 measurements of fasting triglycerides 5 years apart. SETTING: The Staff Periodic Examination Center of the Israel Defense Forces, Zrifin, Israel. PATIENTS: 13,953 apparently healthy, untreated, young men (age 26 to 45 years) with triglyceride levels less than 3.39 mmol/L (<300 mg/dL). MEASUREMENTS: Two triglyceride measurements (at enrollment [time 1] and 5 years later [time 2]), lifestyle variables, and incident cases of angiography-proven CHD. RESULTS: Within 5.5 years, 158 new cases of CHD were identified. The multivariate model was adjusted for age; family history; fasting glucose; high-density lipoprotein cholesterol; blood pressure; body mass index; and changes between time 1 and time 2 in body mass index, physical activity, smoking status, and habit of eating breakfast. Investigators categorized triglyceride levels according to low, intermediate, and high tertiles (as measured at time 1 and time 2 [expressed as tertile at time 1/tertile at time 2]). The risk for CHD in men with high-tertile triglyceride levels at time 1 changed depending on the tertile at time 2 (hazard ratios, 8.23 [95% CI, 2.50 to 27.13] for high/high, 6.84 [CI, 1.95 to 23.98] for high/intermediate, and 4.90 [CI, 1.01 to 24.55] for high/low, compared with the stable low/low group). The risk for CHD in men with low-tertile levels at time 1 also changed depending on the tertile at time 2 (hazard ratios, 3.81 [CI, 0.96 to 15.31] for low/intermediate and 6.76 [CI, 1.34 to 33.92] for low/high, compared with the stable low/low group). LIMITATIONS: Participants were healthy and had a low incidence rate of CHD. The study was observational. CONCLUSIONS: Two triglyceride measurements obtained 5 years apart may assist in assessing CHD risk in young men. A decrease in initially elevated triglyceride levels is associated with a decrease in CHD risk compared with stable high triglyceride levels. However, this risk remains higher than in those with persistently low triglyceride levels.
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In the MELANY study, after multivariate adjustment, men in the top quintile of triglyceride levels had a hazard ratio for coronary heart disease of 4.05 (95% CI, 2.68-8.61) compared with the lowest quintile.
“After multivariate adjustment (including age, body mass index, HDL cholesterol, physical activity, fasting glucose, mean arterial blood pressure, smoking), men in the top quintile of triglyceride levels had a hazard ratio for coronary heart disease of 4.05 (95% CI, 2.68 -8.61) compared with the lowest quintile (P ϭ 0.001 for trend) (135).”
From Evaluation and Treatment of Hypertriglyceridemia: An Endocrine Society Clinical Practice Guideline (2012) · cites this paper as [135]
Beyond fasting triglyceride levels, the change in triglyceride levels strongly predicted incident coronary heart disease.
“Beyond fasting triglyceride levels, the change in triglyceride levels strongly predicted incident coronary heart disease (135).”
From Evaluation and Treatment of Hypertriglyceridemia: An Endocrine Society Clinical Practice Guideline (2012) · cites this paper as [135]
At baseline, triglyceride levels in the top quintile were associated with a 4-fold increased risk of CVD compared with the lowest triglyceride quintile, even after adjustment for other risk factors, including HDL-C.
“At baseline, triglyceride levels in the top quintile were associated with a 4-fold increased risk of CVD compared with the lowest triglyceride quintile, even after adjustment for other risk factors, including HDL-C.”
From Triglycerides and Cardiovascular Disease: A Scientific Statement From the American Heart Association (2011) · cites this paper as [37]
In 13,953 men 26 to 45 years old followed for 10.5 years, there were significant correlations between adoption of a favorable lifestyle and a decrease in triglyceride levels.
“In 13 953 men 26 to 45 years old who were followed up for 10.5 years, there were significant correlations between adoption of a favorable lifestyle (eg, weight loss, physical activity) and a decrease in triglyceride levels.”
From Triglycerides and Cardiovascular Disease: A Scientific Statement From the American Heart Association (2011) · cites this paper as [37]
Increases in triglyceride levels over 5 years were directly correlated with incident CVD in the next 5 years.
“Evaluation of the change in triglyceride levels over the first 5 years and incident CVD in the next 5 years found a direct correlation between increases in triglyceride levels and CVD risk.”
From Triglycerides and Cardiovascular Disease: A Scientific Statement From the American Heart Association (2011) · cites this paper as [37]
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Self-citation
Metadata
- Authors
- Tirosh, A., Rudich, A., Shochat, T., Tekes-Manova, D., Israeli, E., Henkin, Y., Kochba, I., & Shai, I.
- Affiliations
- Ben-Gurion University of the Negev (IL)
- Venue
- Annals of Internal Medicine
- Publisher
- American College of Physicians
- Published
- 2007-09-18
- Volume
- 147
- Issue
- 6
- Pages
- 377-385
- ISSN
- 0003-4819 (ISSN-L)
- 1539-3704
- OpenAlex
- W2034235812
- Cited by
- 151
- References
- 31
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 5 · 2022: 4 · 2021: 6 · 2020: 2 · 2019: 9 · 2018: 8 · 2017: 7 · 2016: 6 · 2015: 14 · 2014: 7 · 2013: 11 · 2012: 16
- FWCI
- 11.95
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
- Keywords
- coronary artery disease, young men, cardiovascular risk, incident coronary heart disease
- MeSH terms
- Adult, Coronary Disease, Electrocardiography, Exercise Test, Fasting, Follow-Up Studies, Humans, Israel, Life Style, Male, Middle Aged, Risk Factors, Triglycerides, Incidence
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