Relation of triglyceride levels, fasting and nonfasting, to fatal and nonfatal coronary heart disease
Relation of triglyceride levels, fasting and nonfasting, to fatal and nonfatal coronary heart disease
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DOI：
10.1001/archinte.163.9.1077
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发表时间：
2003-05-12
影响因子：
--
通讯作者：
Neaton, JD
中科院分区：
文献类型：
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作者：
Eberly, LE;Stamler, J;Neaton, JD
背景资料：目前尚不清楚高甘油三酯血症是否是冠心病（CHD）的独立危险因素，以及空腹和非空腹甘油三酯（TG）是否是CHD的独立危险因素。方法：在1973年至1975年期间，共有2809名（共12866名）男性被随机分配到多危险因素干预试验中，在基线时测量空腹和非空腹TG水平，随访CHD发病率和死亡率。采用比例风险回归模型评估空腹和非空腹TG水平与CHD的关系。结果：空腹和非空腹TG水平平均值分别为187和284 mg/dL（2.11和3.21 mmol/L）。空腹组和非空腹组高甘油三酯血症（≥ 200 mg/dL [2.26 mmol/L]）的患病率分别为31%和61%。8年内有175例非致死性或致死性CHD事件，25年内有328例CHD死亡。与TG水平低于200 mg/dL相比，空腹和非空腹高甘油三酯血症冠心病死亡率的危险因素校正风险比分别为1.24（P= 0.09）和1.26（P= 0.07）。对于非致死性或致死性CHD，空腹和非空腹TG水平具有相似的预测性，空腹和非空腹的风险比分别为1.64（P=.004）和1.46（P=.03）。由于回归稀释偏倚，空腹TG水平的这些相关性被低估了56%，非空腹TG水平的衰减可能更大。获得非空腹测量值比空腹测量值更容易，非空腹测量值的高甘油三酯血症患病率高于空腹测量值，同样的危险性增加表明，非空腹TG水平可能比空腹TG水平对危险分层更有用。
Background: It remains unclear whether hypertriglyceridemia is an independent risk factor for coronary heart disease (CHD), and whether fasting and nonfasting triglyceride (TG). levels are equally predictive.Methods: A total of 2809 (of 12866) men randomized during 1973 through 1975 into the Multiple Risk Factor Intervention Trial with fasting and nonfasting TG levels measured at baseline were followed up for CHD incidence and death. Proportional hazards regression models were used to assess associations of fasting and nonfasting TG levels with CHD.Results: Average fasting and nonfasting TG levels were 187 and 284 mg/dL (2.11 and 3.21 mmol/L), respectively. Prevalence of hypertriglyceridemia (200 mg/dL [2.26 mmol/L] or more) was 31% for fasting and 61% for nonfasting. There were 175 nonfatal or fatal CHD events during 8 years and 328 CHD deaths during 25 years. Compared with TG levels less than 200 mg/dL, risk factor-adjusted hazard ratios for CHD mortality for hypertriglyceridemia were 1.24 (P=.09) for fasting and 1.26 (P=.07) for nonfasting. For nonfatal or fatal CHD, fasting and nonfasting TG levels were similarly predictive with hazard ratios of 1.64 (P=.004) for fasting and 1.46 (P=.03) for nonfasting. These associations for fasting TG levels were assessed to be underestimated by 56% because of regression dilution bias, with attenuation likely greater for, nonfasting TG levels.Conclusions: Greater ease of obtaining nonfasting than fasting measurements, greater prevalence of hypertriglyceridemia with nonfasting than fasting values, and similarly increased risk with each indicate that nonfasting TG levels may be more useful than fasting ones for risk stratification.