Authors |
Sarwar N, Danesh J, Eiriksdottir G, Sigurdsson G, Wareham N, Bingham S, Boekholdt SM, Khaw KT, Gudnason V. |
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Title |
Triglycerides and the risk of coronary heart disease: 10,158 incident cases among 262,525 participants in 29 Western prospective studies |
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Full source | Circulation 2007;115:450-8 | |
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Abstract |
BACKGROUND:
Many epidemiological studies have reported on associations between serum
triglyceride concentrations and the risk of coronary heart disease, but
this association has not been reliably quantified. In the present study,
we report 2 separate nested case-control comparisons in 2 different prospective,
population-based cohorts, plus an updated meta-analysis of 27 additional
prospective studies in general Western populations. METHODS AND RESULTS:
Measurements were made in a total of 3582 incident cases of fatal and
nonfatal coronary heart disease and 6175 controls selected from among
the 44,237 men and women screened in the Reykjavik and the European Prospective
Investigation of Cancer (EPIC)-Norfolk studies. Repeat measurements were
obtained an average of 4 years apart in 1933 participants in the EPIC-Norfolk
Study and an average of 12 years apart in 379 participants in the Reykjavik
study. The long-term stability of log-triglyceride values (within-person
correlation coefficients of 0.64 [95% CI, 0.60 to 0.68] over 4 years and
0.63 [95% CI, 0.57 to 0.70] over 12 years) was similar to those of blood
pressure and total serum cholesterol. After adjustment for baseline values
of several established risk factors, the strength of the association was
substantially attenuated, and the adjusted odds ratio for coronary heart
disease was 1.76 (95% CI, 1.39 to 2.21) in the Reykjavik study and 1.57
(95% CI, 1.10 to 2.24) in the EPIC-Norfolk study in a comparison of individuals
in the top third with those in the bottom third of usual log-triglyceride
values. Similar overall findings (adjusted odds ratio, 1.72; 95% CI, 1.56
to 1.90) were observed in an updated meta-analysis involving a total of
10,158 incident coronary heart disease cases from 262,525 participants
in 29 studies. CONCLUSIONS: Available prospective studies in Western populations
consistently indicate moderate and highly significant associations between
triglyceride values and coronary heart disease risk. Because these associations
depend considerably on levels of established risk factors, however, further
studies are needed to help assess the nature of any independent associations. |