Department of Hygiene, Wakayama Medical University.
Department of Preventive Cardiology, National Cerebral and Cardiovascular Center.
J Atheroscler Thromb. 2021 Dec 1;28(12):1275-1288. doi: 10.5551/jat.62730. Epub 2021 May 28.
A prospective cohort study in a Japanese urban general population was performed to investigate whether triglyceride (TG) and its related indices were associated with the risk for the incidence of ischemic cardiovascular disease (CVD) after the adjustment for low-density lipoprotein cholesterol (LDL-C) in Asian community dwellers.
A 15.1-year prospective cohort study was performed in 6,684 Japanese community dwellers aged 30-79 years without a history of CVD and whose fasting TG levels were ＜400 mg/dL. After adjusting for covariates, including LDL-C, the multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of the deciles (D) of TG and those of 1-standard deviation (SD) increment of log-transformed TG (1-SD of TG) according to LDL-C level (≥ 140 and ＜140 mg/dL) for ischemic CVD incidence were estimated. The multivariable-adjusted HRs and 95%CIs of the quintiles (Q) of TG, TG/HDL-C, and the cardiometabolic index (CMI) for ischemic CVD were also estimated.
In 101,230 person-years, 464 ischemic CVD cases occurred. For D of TG, the HR (95%CI) was 1.56 (1.05-2.32), and for 1-SD of TG, it was 1.30 (1.00-1.70) in participants with LDL-C ＜140 mg/dL and 1.07 (0.77-1.50) in those with LDL-C ≥ 140 mg/dL. For Q of the CMI, the multivariable-adjusted HR was higher than those of TG and TG/HDL-C.
Fasting TG was an independent predictor for ischemic CVD incidence after adjusting for LDL-C in Japanese community dwellers with TG ＜400 mg/dL. Among TG, TG/HDL-C, and the CMI, the CMI could be the most powerful predictor for ischemic CVD.
在日本城市普通人群中进行了一项前瞻性队列研究，旨在探讨在调整亚洲社区居民的低密度脂蛋白胆固醇（LDL-C）后，甘油三酯（TG）及其相关指标是否与缺血性心血管疾病（CVD）的发病风险相关。
对 6684 名年龄在 30-79 岁、无 CVD 病史且空腹 TG 水平＜400mg/dL 的日本社区居民进行了为期 15.1 年的前瞻性队列研究。在调整了包括 LDL-C 在内的混杂因素后，根据 LDL-C 水平（≥140 和＜140mg/dL），计算了 TG 十等分（D）和 TG 对数转换（1-SD of TG）每增加 1 个标准差（SD）的多变量校正后的危险比（HR）和 95%置信区间（CI）与缺血性 CVD 发病率的关系。还根据 TG、TG/HDL-C 和代谢综合征心血管危险指数（CMI）的五分位数（Q），估计了 TG、TG/HDL-C 和 CMI 与缺血性 CVD 的多变量校正 HR 和 95%CI。
在 101230 人年中，发生了 464 例缺血性 CVD 事件。对于 LDL-C＜140mg/dL 的患者，TG 十等分（D）的 HR（95%CI）为 1.56（1.05-2.32），TG 增加 1 个 SD 的 HR（95%CI）为 1.30（1.00-1.70），而 LDL-C≥140mg/dL 的患者分别为 1.07（0.77-1.50）和 1.30（1.00-1.70）。对于 CMI 的五分位数（Q），多变量校正后的 HR 高于 TG 和 TG/HDL-C。
在 LDL-C ＜400mg/dL 的日本社区居民中，空腹 TG 是缺血性 CVD 发病的独立预测因子。在 TG、TG/HDL-C 和 CMI 中，CMI 可能是缺血性 CVD 的最强预测因子。
