Plasma triglyceride level is a risk factor for cardiovascular disease independent of high-density lipoprotein cholesterol level: a meta-analysis of population-based prospective studies.
Plasma triglyceride level is a risk factor for cardiovascular disease independent of high-density lipoprotein cholesterol level: a meta-analysis of population-based prospective studies.
复制标题
DOI：
10.1097/00043798-199604000-00014
复制
发表时间：
1996-04-01
期刊：
影响因子：
--
通讯作者：
Austin, M A
中科院分区：
文献类型：
--
作者：
Hokanson, J E;Austin, M A
结论：尽管近40年的研究，血浆甘油三酯作为心血管疾病的危险因素的作用仍然难以捉摸。本研究的目的是量化甘油三酯和心血管疾病之间的关联在一般人群中的大小，并确定这种关系是否是独立的高密度脂蛋白（HDL）胆固醇，使用荟萃分析的半定量技术。方法和设计：根据已发表的基于人群的前瞻性研究报告，选择了17项研究进行分析，其中包括46413名男性和10864名女性。为了确保可比性，仅纳入了报告空腹甘油三酯水平与心血管事件终点之间相关性的研究。使用标准荟萃分析计算，计算相对风险（RR）和95%置信区间（CI），并将其标准化为甘油三酯增加1 mmol/l。对6项男性研究和2项女性研究进行了多变量调整后的RR测定，这些研究报告了HDL胆固醇的调整。对于男性和女性，甘油三酯的单变量RR为1.32（95% CI 1.26-1.39）和1.76（95% CI 1.50-2.07），表明男性风险增加约30%，女性风险增加约75%。调整高密度脂蛋白胆固醇和其他危险因素后，RR降至1.14（95% CI 1.05-1.28）和1.37（95%CI 1.13-1.66），仍有统计学意义。根据前瞻性研究的综合数据，甘油三酯是一般人群中男性和女性心血管疾病的危险因素，与HDL胆固醇无关。这些发现表明有必要进行临床试验，以评估降低血浆甘油三酯是否会降低心血管疾病的风险。
OBJECTIVES: Despite nearly 40 years of research, the role of plasma triglyceride as a risk factor for cardiovascular disease remains elusive. The objectives of the present study were to quantify the magnitude of the association between triglyceride and cardiovascular disease in the general population, and to determine whether this relationship is independent of high-density lipoprotein (HDL) cholesterol, using the semi-quantitative techniques of metaanalysis.METHODS AND DESIGN: Seventeen studies were selected for the analysis based on published reports of population-based, prospective studies, including 46413 men and 10864 women. To insure comparability, only studies reporting the association between fasting triglyceride levels and incident cardiovascular endpoints were included. Using standard meta-analysis calculations, relative risks (RR) and 95% confidence intervals (CI) were calculated and standardized with respect to a 1 mmol/l increase in triglyceride. Multivariable-adjusted RRs were determined for the six studies in men and two studies in women that reported adjustments for HDL cholesterol.RESULTS: For men and women, the univariate RRs for triglyceride were 1.32 (95% Cl 1.26-1.39) and 1.76 (95% Cl 1.50-2.07), respectively, indicating an approximately 30% increased risk in men and a 75% increase in women. Adjustment of HDL cholesterol and other risk factors attenuated these RRs to 1.14 (95% Cl 1.05-1.28) and 1.37 (95% Cl 1.13-1.66), respectively, which were still statistically significant values.CONCLUSION: Based on combined data from prospective studies, triglyceride is a risk factor for cardiovascular disease for both men and women in the general population, independent of HDL cholesterol. These finding demonstrate the necessity for clinical trials to evaluate whether lowering plasma triglyceride decreases the risk of cardiovascular disease.