Tirosh Amir, Rudich Assaf, Shochat Tzippora, Tekes-Manova Dorit, Israeli Eran, Henkin Yaakov, Kochba Ilan, Shai Iris
Sheba Medical Center, Tel-Hashomer, Israel.
Ann Intern Med. 2007 Sep 18;147(6):377-85. doi: 10.7326/0003-4819-147-6-200709180-00007.
Current triglyceride levels might be only a weak predictor of risk for coronary heart disease (CHD).
To assess the association between changes over time in fasting triglyceride levels and CHD risk in young adults.
Follow-up study over 5.5 years after 2 measurements of fasting triglycerides 5 years apart.
The Staff Periodic Examination Center of the Israel Defense Forces, Zrifin, Israel.
13,953 apparently healthy, untreated, young men (age 26 to 45 years) with triglyceride levels less than 3.39 mmol/L (<300 mg/dL).
Two triglyceride measurements (at enrollment [time 1] and 5 years later [time 2]), lifestyle variables, and incident cases of angiography-proven CHD.
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).
Participants were healthy and had a low incidence rate of CHD. The study was observational.
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.
目前的甘油三酯水平可能只是冠心病（CHD）风险的一个较弱预测指标。
评估年轻成年人空腹甘油三酯水平随时间变化与冠心病风险之间的关联。
在相隔5年的两次空腹甘油三酯测量后进行5.5年的随访研究。
以色列兹里芬以色列国防军员工定期检查中心。
13953名表面健康、未经治疗的年轻男性（年龄26至45岁），甘油三酯水平低于3.39 mmol/L（<300 mg/dL）。
两次甘油三酯测量（入组时[时间1]和5年后[时间2]）、生活方式变量以及经血管造影证实的冠心病发病病例。
在5.5年内，确定了158例新的冠心病病例。多变量模型根据年龄、家族病史、空腹血糖、高密度脂蛋白胆固醇、血压、体重指数以及时间1和时间2之间体重指数、身体活动、吸烟状况和吃早餐习惯的变化进行了调整。研究人员根据低、中、高三分位数对甘油三酯水平进行分类（在时间1和时间2测量[表示为时间1的三分位数/时间2的三分位数]）。时间1时处于高三分位甘油三酯水平的男性患冠心病的风险根据时间2的三分位数而变化（风险比，高/高为8.23[95%CI，2.50至27.13]，高/中为6.84[CI，1.95至23.98]，高/低为4.90[CI，1.01至24.55]，与稳定的低/低组相比）。时间1时处于低三分位水平的男性患冠心病的风险也根据时间2的三分位数而变化（风险比，低/中为3.81[CI，0.96至15.31]，低/高为6.76[CI，1.34至33.92]，与稳定的低/低组相比）。
参与者健康，冠心病发病率低。该研究为观察性研究。
相隔5年进行的两次甘油三酯测量可能有助于评估年轻男性的冠心病风险。与稳定的高甘油三酯水平相比，最初升高的甘油三酯水平降低与冠心病风险降低相关。然而，这种风险仍高于甘油三酯水平持续较低的人群。
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