Jiao Zhen-Yu, Li Xiao-Tao, Li Yan-Bing, Zheng Mei-Li, Cai Jun, Chen Shuo-Hua, Wu Shou-Ling, Yang Xin-Chun
The Heart Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China.
Department of Senile Disease, Beijing Wujing Zongdui Hospital, Beijing 100027, China.
J Thorac Dis. 2018 May;10(5):2551-2557. doi: 10.21037/jtd.2018.04.132.
This study aims to investigate the associations of different (low/medium/high) levels of fasting triglyceride (TG) levels with cardiovascular endpoints.
This cohort study comprised of in-service and retired employees of the Kailuan Coal Mine Group, who participated in the health examination conducted in 11 hospitals in the Kailuan region from June 2006 to October 2007 (n=100,271). The study population was divided into five groups according to different TG levels. Logistic regression analysis was used to analyze the risk factors for myocardial infarction (MI) in patients with elevated TG, and Cox proportional hazards regression analysis was used to analyze the effects of different TG levels on endpoint events.
After a median follow-up of 7 years, 961 patients developed MI and 3,142 subjects died. The multivariate logistic regression analysis revealed that elevated TG, an age of ≥65 years old, body mass index (BMI) >25 kg/m, fasting blood glucose (FBG) ≥6.1 mmol/L and high density lipoprotein cholesterol (HDL-C) <1.5 mmol/L were all risk factors for MI (P<0.05). Furthermore, Cox proportional hazards regression model revealed that after controlling for gender, age and other factors, with the increase in TG level, the relative risk of MI also increased. Compared to the TG1 group, the risk of MI increased to 1.32 folds in the TG4 group (95% CI: 1.05-1.66, P=0.018) and 1.61 folds in the TG5 group (95% CI: 1.21-1.93, P=0.004). Furthermore, the risk of MI combined with all-cause death and all-cause death also increased, but the differences were not all statistically significant.
In the study population of the Kailuan region, elevated fasting TG increases the risk of MI, particularly in populations with an age of ≥65 years old, BMI >25 kg/m, FBG ≥6.1 mmol/L and HDL-C <1.5 mmol/L.
本研究旨在调查不同(低/中/高)水平的空腹甘油三酯(TG)与心血管终点事件之间的关联。
这项队列研究纳入了开滦煤矿集团在职和退休员工,他们于2006年6月至2007年10月期间在开滦地区的11家医院参加了健康检查(n = 100,271)。研究人群根据不同的TG水平分为五组。采用逻辑回归分析来分析TG升高患者心肌梗死(MI)的危险因素,采用Cox比例风险回归分析来分析不同TG水平对终点事件的影响。
中位随访7年后,961例患者发生MI,3142例受试者死亡。多因素逻辑回归分析显示,TG升高、年龄≥65岁、体重指数(BMI)>25 kg/m、空腹血糖(FBG)≥6.1 mmol/L和高密度脂蛋白胆固醇(HDL-C)<1.5 mmol/L均为MI的危险因素(P<0.05)。此外,Cox比例风险回归模型显示,在控制性别、年龄等因素后,随着TG水平的升高,MI的相对风险也增加。与TG1组相比,TG4组MI风险增加至1.32倍(95%CI:1.05 - 1.66,P = 0.018),TG5组增加至1.61倍(95%CI:1.21 - 1.93,P = 0.004)。此外,MI合并全因死亡和全因死亡的风险也增加,但差异并非均具有统计学意义。
在开滦地区的研究人群中,空腹TG升高会增加MI风险,尤其是在年龄≥65岁、BMI>25 kg/m、FBG≥6.1 mmol/L和HDL-C<1.5 mmol/L的人群中。