Guo Li-Ling, Zhu Li-Yuan, Xu Jin, Xie Ying-Ying, Xiang Qun-Yan, Jiang Zhe-Yi, Tan Yang-Rong, Liu Ling
Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.
Research institute of Blood Lipid and Atherosclerosis, Center South University, Changsha, China.
Front Cardiovasc Med. 2021 Sep 24;8:736059. doi: 10.3389/fcvm.2021.736059. eCollection 2021.
The level of triglyceride (TG) ≥ 2. 3 mmol/L is suggestive of marked hypertriglyceridemia (HTG) and requires treatment with a triglyceride-lowering agent in high-risk and very high-risk patients as recommended by the 2019 ESC/EAS guidelines for the management of dyslipidemia. However, the optimal cutoff value required to diagnose non-fasting HTG that corresponds to the fasting goal level of 2.3 mmol/L in Chinese subjects is unknown. This study enrolled 602 cardiology inpatients. Blood lipid levels, including calculated non-high-density lipoprotein cholesterol (non-HDL-C) and remnant cholesterol (RC), were measured at 0, 2, and 4 h after a daily Chinese breakfast. Of these, 482 inpatients had TG levels of <2.3 mmol/L (CON group) and 120 inpatients had TG levels of ≥2.3 mmol/L (HTG group). Receiver operating characteristic (ROC) curve analysis was used to determine the cutoff values for postprandial HTG that corresponded to a target fasting level of 2.3 mmol/L. Marked hypertriglyceridemia (≥2.3 mmol/L) was found in 120 (19.9%) patients in this study population. The levels of non-fasting TG and RC increased significantly in both groups and reached the peak at 4 h after a daily meal, especially in the HTG group ( < 0.05). The optimal cutoff value of TG at 4 h, which corresponds to fasting TG of ≥2.3 mmol/L, that can be used to predict HTG, was 2.66 mmol/L. According to the new non-fasting cutoff value, the incidence of non-fasting HTG is close to its fasting level. In summary, this is the first study to determine the non-fasting cutoff value that corresponds to a fasting TG of ≥2.3 mmol/L in Chinese patients. Additionally, 2.66 mmol/l at 4 h after a daily meal could be an appropriate cutoff value that can be used to detect non-fasting marked HTG in Chinese subjects.
甘油三酯（TG）水平≥2.3 mmol/L提示明显的高甘油三酯血症（HTG），对于高危和极高危患者，需要按照2019年欧洲心脏病学会/欧洲动脉粥样硬化学会血脂异常管理指南的建议，使用降低甘油三酯的药物进行治疗。然而，在中国受试者中，用于诊断非空腹HTG且对应空腹目标水平2.3 mmol/L所需的最佳临界值尚不清楚。本研究纳入了602名心内科住院患者。在每日中餐后0、2和4小时测量血脂水平，包括计算得出的非高密度脂蛋白胆固醇（non-HDL-C）和残余胆固醇（RC）。其中，482名住院患者的TG水平<2.3 mmol/L（CON组），120名住院患者的TG水平≥2.3 mmol/L（HTG组）。采用受试者工作特征（ROC）曲线分析来确定对应空腹目标水平2.3 mmol/L的餐后HTG临界值。在本研究人群中，120名（19.9%）患者存在明显的高甘油三酯血症（≥2.3 mmol/L）。两组的非空腹TG和RC水平均显著升高，并在每日餐后4小时达到峰值，尤其是在HTG组（<0.05）。4小时时TG的最佳临界值为2.66 mmol/L，该值对应空腹TG≥2.3 mmol/L，可用于预测HTG。根据新的非空腹临界值，非空腹HTG的发生率接近其空腹水平。总之，这是第一项确定中国患者中对应空腹TG≥2.3 mmol/L的非空腹临界值的研究。此外，每日餐后4小时的2.66 mmol/L可能是一个合适的临界值，可用于检测中国受试者的非空腹明显HTG。
