Koo Bo Kyung, Park SangHyun, Han Kyung-Do, Moon Min Kyong
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Division of Endocrinology, Department of Internal Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea.
J Lipid Atheroscler. 2021 Jan;10(1):88-98. doi: 10.12997/jla.2021.10.1.88. Epub 2021 Jan 5.
This study was conducted to estimate the incidence of cardiovascular disease (CVD) independently from low-density lipoprotein (LDL) cholesterol according to triglyceride (TG) levels in young adults.
Subjects aged 30-49 years with data from routine health check-ups provided by the National Health Insurance Service during 2009 were selected. The primary outcome was incident CVD, defined as a composite of ischemic heart disease and ischemic stroke during the follow-up period from 2009 to 2018.
The mean age of study subjects (n=1,823,537) was 40.1±5.7 years, and the median follow-up period was 8.3 years. The quartiles of serum TG levels at the baseline were calculated: Q1, <74 mg/dL; Q2, 74-108 mg/dL; Q3, 109-166 mg/dL; and Q4: >166 mg/dL. The highest quartile of TG levels (Q4) had a significantly higher risk of the primary outcome than Q1 (hazard ratio [HR], 2.40 [95% confidence interval; CI, 2.33-2.47]). Q2 and Q3 also experienced the primary outcome more frequently than Q1 (HR, 1.37 [95% CI, 1.33-1.42] and HR, 1.80 [95% CI, 1.75-1.86], respectively). Even after adjustment for age, sex, obesity, alcohol drinking amount, smoking, LDL cholesterol, diabetes mellitus, hypertension, lipid-lowering medication use, and family history of CVD, there was a significant dose-response relationship between TG quartiles and the risk of the primary outcome (HR per quartile, 1.13 [95% CI, 1.12-1.14]).
In conclusion, in the Korean population aged 30-49 years, high TG levels independently increased future CVD risk in both men and women.
本研究旨在根据年轻成年人的甘油三酯(TG)水平,独立于低密度脂蛋白(LDL)胆固醇来估计心血管疾病(CVD)的发病率。
选取2009年期间由国民健康保险服务提供的常规健康检查数据的30 - 49岁受试者。主要结局为发生CVD,定义为2009年至2018年随访期间缺血性心脏病和缺血性卒中的复合情况。
研究对象(n = 1,823,537)的平均年龄为40.1±5.7岁,中位随访期为8.3年。计算了基线时血清TG水平的四分位数:Q1,<74 mg/dL;Q2,74 - 108 mg/dL;Q3,109 - 166 mg/dL;Q4:>166 mg/dL。TG水平最高的四分位数(Q4)发生主要结局的风险显著高于Q1(风险比[HR],2.40 [95%置信区间;CI,2.33 - 2.47])。Q2和Q3发生主要结局的频率也高于Q1(HR分别为1.37 [95% CI,1.33 - 1.42]和HR,1.80 [95% CI,1.75 - 1.86])。即使在调整了年龄、性别、肥胖、饮酒量、吸烟、LDL胆固醇、糖尿病、高血压、降脂药物使用和CVD家族史后,TG四分位数与主要结局风险之间仍存在显著的剂量反应关系(每四分位数HR,1.13 [95% CI,1.12 -