基于甘油三酯的筛查试验未能识别非洲移民和非裔美国男性的心血管代谢疾病。
Triglyceride-based screening tests fail to recognize cardiometabolic disease in African immigrant and African-American men.
机构信息
Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes, Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland 20892-1612, USA.
出版信息
Metab Syndr Relat Disord. 2013 Feb;11(1):15-20. doi: 10.1089/met.2012.0114. Epub 2012 Dec 5.
BACKGROUND
The prevalence of cardiometabolic disease in Africa now rivals that of Western nations. Therefore, screening programs that lead to effective prevention of cardiometabolic disease in Africans is imperative. Most screening tests for cardiometabolic disease use triglyceride (TG) levels as a criterion. However, the failure rate of TG-based screening tests in African Americans is high. In Africans, the efficacy of TG-based screening tests is unknown. Our goal was to determine the association between hypertriglyceridemia (TG ≥150 mg/dL) and cardiometabolic disease in African and African-American men.
RESEARCH DESIGN AND METHODS
This was a cross-sectional study of 155 men (80 African immigrants, 75 African Americans) [age, 35±9 years, mean±standard deviation (SD), body mass index (BMI) 28.5±5.2 kg/m(2)] who self-identified as healthy. Lipid profiles were performed. Glucose tolerance and insulin resistance was determined by oral glucose tolerance tests (OGTT) and the insulin sensitivity index (S(I)), respectively. Cardiometabolic disease was defined by four possible subtypes--prediabetes, diabetes, insulin resistance, or metabolic triad [hyperinsulinemia, hyperapolipoprotein B, small low-density lipoprotein (LDL) particles].
RESULTS
TG levels were higher in men with cardiometabolic disease than without (88±43 versus 61±26 mg/dL, P<0.01). However, <10% of men with cardiometabolic disease had TG ≥150 mg/dL. Even within each cardiometabolic disease subtype, the prevalence of TG ≥150 mg/dL was <10%. Furthermore, TG levels in the 5% of men identified by OGTT as diabetic were ≤100 mg/dL (mean 71±24, range 45-100 mg/dL).
CONCLUSIONS
Hypertriglyceridemia is a poor marker of cardiometabolic disease in men of African descent. Therefore TG-based screening tests fail to identify both African immigrants and African-American men with cardiometabolic disease. As a consequence, the opportunity for early intervention and prevention is lost.
背景
非洲心血管代谢疾病的患病率现已与西方国家相当。因此，在非洲人群中开展能有效预防心血管代谢疾病的筛查项目已刻不容缓。大多数心血管代谢疾病的筛查检测都将甘油三酯（TG）水平作为一个标准。然而，在非裔美国人中，基于 TG 的筛查检测的失败率很高。在非洲人群中，基于 TG 的筛查检测的效果尚不清楚。我们的目标是确定高甘油三酯血症（TG≥150mg/dL）与非洲裔和非裔美国男性心血管代谢疾病之间的关联。
研究设计和方法
这是一项横断面研究，纳入了 155 名男性（80 名非洲移民，75 名非裔美国人）[年龄 35±9 岁，平均值±标准差（SD），体重指数（BMI）28.5±5.2kg/m²]，他们自我认定为健康人群。检测了血脂谱。通过口服葡萄糖耐量试验（OGTT）和胰岛素敏感性指数（S（I））分别确定葡萄糖耐量和胰岛素抵抗。心血管代谢疾病通过四种可能的亚型定义——糖尿病前期、糖尿病、胰岛素抵抗或代谢三联征[高胰岛素血症、高载脂蛋白 B、小而密低密度脂蛋白（LDL）颗粒]。
结果
患有心血管代谢疾病的男性的 TG 水平高于无心血管代谢疾病的男性（88±43 与 61±26mg/dL，P<0.01）。然而，只有不到 10%的患有心血管代谢疾病的男性的 TG≥150mg/dL。即使在每个心血管代谢疾病亚型中，TG≥150mg/dL 的患病率也不到 10%。此外，通过 OGTT 确定为糖尿病的男性中，5%的人的 TG 水平≤100mg/dL（平均值 71±24，范围 45-100mg/dL）。
结论
高甘油三酯血症是非洲裔男性心血管代谢疾病的一个较差的标志物。因此，基于 TG 的筛查检测未能识别出患有心血管代谢疾病的非洲移民和非裔美国男性。因此，错失了早期干预和预防的机会。
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