Hadaegh F, Khalili D, Ghasemi A, Tohidi M, Sheikholeslami F, Azizi F
Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University (M.C.), P.O. Box. Tehran 19395-4763, Iran.
Nutr Metab Cardiovasc Dis. 2009 Jul;19(6):401-8. doi: 10.1016/j.numecd.2008.09.003. Epub 2008 Dec 16.
To determine whether triglyceride/high-density lipoprotein cholesterol ratio (TG/HDL-C), which has been shown to be an indicator of the metabolic syndrome (MetS) and insulin resistance, can predict coronary heart disease (CHD) independently of total cholesterol (TC) and other risk factors in an Iranian population with a high prevalence of MetS and low HDL-C.
Between February 1999 and August 2001, 1824 men > or =40 years old, free of clinical cardiovascular diseases at baseline, were followed. Baseline measurements included serum level of TC, HDL-C, TG and risk factors for CHD including age, systolic and diastolic blood pressure, body mass index, waist circumference, diabetes, smoking and a family history of premature cardiovascular diseases. During a median follow up of 6.5 years until March 2007 (11,316 person-years at risk), a total of 163 new CHD events (27 fatal and 136 nonfatal) occurred. The prevalence of MetS in subjects with TG/HDL-C > or =6.9 (top quartile) reached 63.6% versus 3.0% in those with TG/HDL-C <2.8 (low quartile). According to a stepwise Cox proportional hazard model, including TG and TG/HDL-C quartiles, with TC and other risk factors, men in the top quartile of TG/HDL-C relative to the first quartile had a significant hazard ratio (HR) of 1.75 (95% CI, 1.02-3.00), while TG did not remain in the model.
The evaluation of TG/HDL-C ratio should be considered for CHD risk prediction in our male population with a high prevalence of MetS.
已证明甘油三酯/高密度脂蛋白胆固醇比值(TG/HDL-C)是代谢综合征(MetS)和胰岛素抵抗的一项指标,本研究旨在确定在代谢综合征患病率高且高密度脂蛋白胆固醇水平低的伊朗人群中,TG/HDL-C是否能独立于总胆固醇(TC)及其他危险因素预测冠心病(CHD)。
在1999年2月至2001年8月期间,对1824名年龄≥40岁、基线时无临床心血管疾病的男性进行随访。基线测量包括TC、HDL-C、TG的血清水平以及冠心病的危险因素,包括年龄、收缩压和舒张压、体重指数、腰围、糖尿病、吸烟和早发心血管疾病家族史。在至2007年3月的中位随访6.5年期间(11316人年的风险期),共发生163例新发冠心病事件(27例致死性和136例非致死性)。TG/HDL-C≥6.9(最高四分位数)的受试者中代谢综合征患病率达63.6%,而TG/HDL-C<2.8(最低四分位数)的受试者中该患病率为3.0%。根据逐步Cox比例风险模型,纳入TG和TG/HDL-C四分位数以及TC和其他危险因素,TG/HDL-C最高四分位数相对于第一四分位数的男性具有显著风险比(HR)1.75(95%CI,(1.02 - 3.00)),而TG未保留在模型中。
对于我们这个代谢综合征患病率高的男性人群,在冠心病风险预测中应考虑评估TG/HDL-C比值。