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日本一般人群 20 年随访研究中非空腹甘油三酯与心血管疾病死亡率的关系:NIPPON DATA90。

Relationship Between Non-fasting Triglycerides and Cardiovascular Disease Mortality in a 20-year Follow-up Study of a Japanese General Population: NIPPON DATA90.

机构信息

Department of Preventive Medicine and Public Health, Keio University School of Medicine.

Department of Public Health, Hokkaido University Faculty of Medicine.

出版信息

J Epidemiol. 2022 Jul 5;32(7):303-313. doi: 10.2188/jea.JE20200399. Epub 2021 Jun 22.


DOI:10.2188/jea.JE20200399
PMID:33456020
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9189318/
Abstract

BACKGROUND: Non-fasting triglycerides (TG) are considered a better predictor of cardiovascular disease (CVD) than fasting TG. However, the effect of non-fasting TG on fatal CVD events remains unclear. In the present study, we aimed to explore the relationship between non-fasting TG and CVD mortality in a Japanese general population. METHODS: A total of 6,831 participants without a history of CVD, in which those who had a blood sampling over 8 hours or more after a meal were excluded, were followed for 18.0 years. We divided participants into seven groups according to non-fasting TG levels: ≤59 mg/dL, 60-89 mg/dL, 90-119 mg/dL, 120-149 mg/dL, 150-179 mg/dL, 180-209 mg/dL, and ≥210 mg/dL, and estimated the multivariable-adjusted hazard ratios (HRs) of each TG group for CVD mortality after adjusting for potential confounders, including high density lipoprotein cholesterol. Additionally, we performed analysis stratified by age <65 and ≥65 years. RESULTS: During the follow-up period, 433 deaths due to CVD were detected. Compared with a non-fasting TG of 150-179 mg/dL, non-fasting TG ≥210 mg/dL was significantly associated with increased risk for CVD mortality (HR 1.56: 95% CI, 1.01-2.41). Additionally, lower levels of non-fasting TG were also significantly associated with increased risk for fatal CVD. In participants aged ≥65 years, lower levels of non-fasting TG had a stronger impact on increased risk for CVD mortality, while higher levels of non-fasting TG had a stronger impact in those aged <65 years. CONCLUSION: In a general Japanese population, we observed a U-shaped association between non-fasting TG and fatal CVD events.

摘要

背景:非空腹甘油三酯(TG)被认为比空腹 TG 更能预测心血管疾病(CVD)。然而,非空腹 TG 对致命 CVD 事件的影响尚不清楚。在本研究中,我们旨在探讨日本一般人群中非空腹 TG 与 CVD 死亡率之间的关系。

方法:共有 6831 名无 CVD 病史的参与者,其中排除了餐后采血 8 小时以上的参与者,随访时间为 18.0 年。我们根据非空腹 TG 水平将参与者分为七组:≤59mg/dL、60-89mg/dL、90-119mg/dL、120-149mg/dL、150-179mg/dL、180-209mg/dL 和≥210mg/dL,并调整了高密度脂蛋白胆固醇等潜在混杂因素后,估计每个 TG 组的 CVD 死亡率的多变量调整后的危险比(HR)。此外,我们还按年龄<65 岁和≥65 岁进行了分层分析。

结果:在随访期间,检测到 433 例 CVD 死亡。与非空腹 TG 为 150-179mg/dL 相比,非空腹 TG≥210mg/dL 与 CVD 死亡率增加显著相关(HR 1.56:95%CI,1.01-2.41)。此外,非空腹 TG 水平较低也与致命 CVD 的风险增加显著相关。在年龄≥65 岁的参与者中,非空腹 TG 水平较低对 CVD 死亡率增加的影响更强,而在年龄<65 岁的参与者中,非空腹 TG 水平较高对 CVD 死亡率增加的影响更强。

结论:在日本一般人群中,我们观察到非空腹 TG 与致命 CVD 事件之间呈 U 形关联。

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[2]
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[3]
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[6]
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[7]
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[8]
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[9]
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本文引用的文献

[1]
The triglyceride paradox in the mortality of coronary artery disease.

Lipids Health Dis. 2019-1-22

[2]
Triglycerides Paradox Among the Oldest Old: "The Lower the Better?".

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J Atheroscler Thromb. 2018-9-1

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A Test in Context: Lipid Profile, Fasting Versus Nonfasting.

J Am Coll Cardiol. 2017-9-26

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Impacts of chronic kidney disease and diabetes on cardiovascular mortality in a general Japanese population: A 20-year follow-up of the NIPPON DATA90 study.

Eur J Prev Cardiol. 2017-3

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J Atheroscler Thromb. 2016-7-1

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The Triglyceride Paradox in Stroke Survivors: A Prospective Study.

Neurosci J. 2013

[10]
Fasting and non-fasting triglycerides and risk of ischemic cardiovascular disease in Japanese men and women: the Circulatory Risk in Communities Study (CIRCS).

Atherosclerosis. 2014-11

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