Identifying cardiovascular disease risk and outcome: use of the plasma triglyceride/high-density lipoprotein cholesterol concentration ratio versus metabolic syndrome criteria
Identifying cardiovascular disease risk and outcome: use of the plasma triglyceride/high-density lipoprotein cholesterol concentration ratio versus metabolic syndrome criteria
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DOI：
10.1111/joim.12036
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发表时间：
2013-06-01
影响因子：
11.1
通讯作者：
Reaven, G. M.
中科院分区：
文献类型：
--
作者：
Salazar, M. R.;Carbajal, H. A.;Reaven, G. M.
背景代谢综合征（MetS）已被证明可以预测风险和CVD事件。我们已经确定了性别特异性的甘油三酯/高密度脂蛋白胆固醇（TG/HDL-C）比值与不利的心脏代谢风险相关，但尚不清楚它是否也预测CVD的结果。方法为了量化与高TG/HDL-C比值相关的CVD结局风险，并将该风险与MetS预测的风险进行比较，在阿根廷布宜诺斯艾利斯的Rauch市进行了一项人群纵向前瞻性观察研究。2003年，对926名居民的人口随机样本进行了调查。2012年，527名女性和269名男性再次接受调查，以寻找新的CVD事件。第一起CVD事件是主要终点。使用考克斯比例风险估计TG/HDL-C临界点以上和以下，以及有或无MetS的个体之间CVD事件的相对风险。主要终点：首次CVD事件为主要终点。使用考克斯比例风险估计TG/HDL-C临界点以上和以下，以及有或无MetS的个体之间CVD事件的相对风险。结果根据TG/HDL-C比值升高（30%）或MetS（35%）被视为高CVD风险的受试者人数相对相当。无论使用哪种标准，当比较高风险组与低风险组时，未调整的危险风险显著增加，尽管MetS组的危险风险略高（HR=3.17，95% CI：1.795.60 vs. 2.16，95% CI：1.243.75）。然而，当调整性别和年龄后，这种差异基本消失（MetS和TG/HDL-C的HR=2.09，95% CI：1.183.72 vs. 2.01，95% CI：1.143.50）。结论TG/HDL-C比值升高与MetS诊断在预测CVD发展方面同样有效。
Background Metabolic syndrome (MetS) has been shown to predict both risk and CVD events. We have identified sex-specific values for the triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio associated with an unfavourable cardio-metabolic risk profile, but it is not known whether it also predicts CVD outcome. Methods To quantify risk for CVD outcomes associated with a high TG/HDL-C ratio and to compare this risk with that predicted using MetS, a population longitudinal prospective observational study was performed in Rauch City, Buenos Aires, Argentina. In 2003 surveys were performed on a population random sample of 926 inhabitants. In 2012, 527 women and 269 men were surveyed again in search of new CVD events. The first CVD event was the primary endpoint. Relative risks for CVD events between individuals above and below the TG/HDL-C cut-points, and with or without MetS, were estimated using Cox proportional hazard. Main Outcome The first CVD event was the primary endpoint. Relative risks for CVD events between individuals above and below the TG/HDL-C cut-points, and with or without MetS, were estimated using Cox proportional hazard. Results The number of subjects deemed at high' CVD risk on the basis of an elevated TG/HDL-C ratio (30%) or having the MetS (35%) was relatively comparable. The unadjusted hazard risk was significantly increased when comparing high' versus low' risk groups no matter which criteria was used, although it was somewhat higher in those with the MetS (HR=3.17, 95% CI:1.795.60 vs. 2.16, 95% CI:1.243.75). However, this difference essentially disappeared when adjusted for sex and age (HR=2.09, 95% CI:1.183.72 vs. 2.01, 95% CI:1.143.50 for MetS and TG/HDL-C respectively). Conclusions An elevated TG/HDL-C ratio appears to be just as effective as the MetS diagnosis in predicting the development of CVD.