National Center for Cardiovascular Research (CNIC), Madrid, Spain; Department of Cardiology, Álvaro Cunqueiro University Hospital, Vigo, Spain. Electronic address: https://twitter.com/Borjaibanez1.
National Center for Cardiovascular Research (CNIC), Madrid, Spain; Centro de Investigación Biomédica en Red Consortium for Cardiovascular Diseases (CIBERCV), Madrid, Spain; Department of Cardiology, Son Espases University Hospital, Palma de Mallorca, Spain.
J Am Coll Cardiol. 2021 Jun 22;77(24):3031-3041. doi: 10.1016/j.jacc.2021.04.059.
Even when low-density lipoprotein-cholesterol (LDL-C) levels are lower than guideline thresholds, a residual risk of atherosclerosis remains. It is unknown whether triglyceride (TG) levels are associated with subclinical atherosclerosis and vascular inflammation regardless of LDL-C.
This study sought to assess the association between serum TG levels and early atherosclerosis and vascular inflammation in apparently healthy individuals.
An observational, longitudinal, and prospective cohort study, including 3,754 middle-aged individuals with low to moderate cardiovascular risk from the PESA (Progression of Early Subclinical Atherosclerosis) study who were consecutively recruited between June 2010 and February 2014, was conducted. Peripheral atherosclerotic plaques were assessed by 2-dimensional vascular ultrasound, and coronary artery calcification (CAC) was assessed by noncontrast computed tomography, whereas vascular inflammation was assessed by fluorine-18 fluorodeoxyglucose uptake on positron emission tomography.
Atherosclerotic plaques and CAC were observed in 58.0% and 16.8% of participants, respectively, whereas vascular inflammation was evident in 46.7% of evaluated participants. After multivariate adjustment, TG levels ≥150 mg/dl showed an association with subclinical noncoronary atherosclerosis (odds ratio [OR]: 1.35; 95% confidence interval [CI]: 1.08 to 1.68; p = 0.008). This association was significant for groups with high LDL-C (OR: 1.42; 95% CI: 1.11 to 1.80; p = 0.005) and normal LDL-C (OR: 1.85; 95% CI: 1.08 to 3.18; p = 0.008). No association was found between TG level and CAC score. TG levels ≥150 mg/dl were significantly associated with the presence of arterial inflammation (OR: 2.09; 95% CI: 1.29 to 3.40; p = 0.003).
In individuals with low to moderate cardiovascular risk, hypertriglyceridemia was associated with subclinical atherosclerosis and vascular inflammation, even in participants with normal LDL-C levels. (Progression of Early Subclinical Atherosclerosis [PESA]; NCT01410318).
即使低密度脂蛋白胆固醇（LDL-C）水平低于指南阈值，动脉粥样硬化的残余风险仍然存在。目前尚不清楚甘油三酯（TG）水平是否与亚临床动脉粥样硬化和血管炎症有关，而与 LDL-C 无关。
本研究旨在评估血清 TG 水平与中低危人群亚临床动脉粥样硬化和血管炎症之间的关系。
这是一项观察性、纵向和前瞻性队列研究，纳入了 2010 年 6 月至 2014 年 2 月连续招募的来自 PESA（早期亚临床动脉粥样硬化进展）研究的 3754 名中低危心血管风险的中年个体。通过二维血管超声评估外周动脉粥样硬化斑块，通过非对比计算机断层扫描评估冠状动脉钙化（CAC），通过正电子发射断层扫描评估氟-18 氟脱氧葡萄糖摄取评估血管炎症。
分别有 58.0%和 16.8%的参与者存在动脉粥样硬化斑块和 CAC，46.7%的参与者存在血管炎症。经多变量调整后，TG 水平≥150mg/dl 与亚临床非冠状动脉粥样硬化相关（比值比[OR]：1.35；95%置信区间[CI]：1.08 至 1.68；p=0.008）。这种相关性在 LDL-C 水平较高（OR：1.42；95%CI：1.11 至 1.80；p=0.005）和正常 LDL-C（OR：1.85；95%CI：1.08 至 3.18；p=0.008）的人群中具有统计学意义。TG 水平与 CAC 评分之间无相关性。TG 水平≥150mg/dl 与动脉炎症的存在显著相关（OR：2.09；95%CI：1.29 至 3.40；p=0.003）。
在中低危心血管风险人群中，即使 LDL-C 水平正常，高甘油三酯血症也与亚临床动脉粥样硬化和血管炎症相关。（早期亚临床动脉粥样硬化进展[PESA]；NCT01410318）。
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