Bos G, Dekker J M, Nijpels G, de Vegt F, Diamant M, Stehouwer C D A, Bouter L M, Heine R J
Institute for Research in Extramural Medicine, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands.
Diabetologia. 2003 Jul;46(7):910-6. doi: 10.1007/s00125-003-1141-5. Epub 2003 Jun 18.
AIMS/HYPOTHESIS: Type 2 diabetes is not only associated with hyperglycaemia, but also with disorders of lipid metabolism. The aim of this study was to investigate the association of triglyceride and non-HDL-cholesterol concentrations with cardiovascular disease in subjects with normal and abnormal glucose metabolism.
Subjects were 869 men and 948 women aged 50 to 75 who participated in the Hoorn Study, a population-based cohort study that started in 1989. Glucose metabolism was determined by a 75 g OGTT. High fasting triglyceride and non-HDL-cholesterol concentrations were defined as above the median of the study population.
After 10 years of follow-up, the age- and sex-adjusted hazard ratios for cardiovascular disease were 1.35 (1.11-1.64) and 1.71 (1.40-2.08) for high triglycerides and high non-HDL-cholesterol, respectively, after mutual adjustment. After stratification for glucose metabolism status, the hazard ratios for cardiovascular disease for non-HDL-cholesterol were 1.70 (1.31-2.21) in normal glucose metabolism and 1.56 (1.12-2.18) in abnormal glucose metabolism. Triglycerides were not a risk factor in subjects with normal glucose metabolism, with a hazard ratio of 0.94 (0.73-1.22), but in subjects with abnormal glucose metabolism, the hazard ratio for cardiovascular disease was 1.54 (1.07-2.22). In subjects with abnormal glucose metabolism, the hazard ratio for the combined presence of high triglycerides and non-HDL-cholesterol was 2.12 (1.35-3.34).
Our data suggest that in people with abnormal glucose metabolism, but not in those with normal glucose metabolism, high triglyceride concentration could be associated with the risk of cardiovascular disease, particularly in people with high non-HDL-cholesterol.
目的/假设：2型糖尿病不仅与高血糖有关，还与脂质代谢紊乱有关。本研究的目的是调查甘油三酯和非高密度脂蛋白胆固醇浓度与糖代谢正常和异常受试者心血管疾病之间的关联。
研究对象为869名男性和948名年龄在50至75岁之间的女性，他们参与了始于1989年的基于人群的队列研究——霍恩研究。通过75克口服葡萄糖耐量试验（OGTT）来测定糖代谢情况。空腹甘油三酯和非高密度脂蛋白胆固醇浓度高于研究人群中位数被定义为高浓度。
经过10年随访，相互调整后，高甘油三酯和高非高密度脂蛋白胆固醇导致心血管疾病的年龄和性别调整后风险比分别为1.35（1.11 - 1.64）和1.71（1.40 - 2.08）。根据糖代谢状态分层后，非高密度脂蛋白胆固醇导致心血管疾病的风险比在糖代谢正常者中为1.70（1.31 - 2.21），在糖代谢异常者中为1.56（1.12 - 2.18）。甘油三酯在糖代谢正常的受试者中不是危险因素，风险比为0.94（0.73 - 1.22），但在糖代谢异常的受试者中，心血管疾病的风险比为1.54（1.07 - 2.22）。在糖代谢异常的受试者中，高甘油三酯和高非高密度脂蛋白胆固醇同时存在时的风险比为2.12（1.35 - 3.34）。
我们的数据表明，在糖代谢异常的人群中，而非糖代谢正常的人群中，高甘油三酯浓度可能与心血管疾病风险相关，尤其是在非高密度脂蛋白胆固醇高的人群中。
