Evaluation of Hypertriglyceridemia using Non-fasting Health Checkup Data in a Japanese Population

Abstract

Aim: Some employees have difficulty undergoing health checkups in the workplace in a fasting state. However, hypertriglyceridemia is usually diagnosed based on fasting triglyceride (TG) measurements. The current study investigated the performance of non-fasting health checkup data for predicting hypertriglyceridemia in a Japanese population. Methods: We recruited a total of 1,959 Japanese employees who had their fasting TG levels reexamined after undergoing initial health checkups under either a fasting (the fasting population; n = 856) or non-fasting state (the non-fasting population; n= 1103). Hypertriglyceridemia was defined as a fasting TG level of ≥ 1.7 mmol/l. Results: The area under the receiver operating characteristic (ROC) curve of the initial TG measurements for reexamination-detected hypertriglyceridemia was 0.85 in the fasting population and 0.83 in the non-fasting population. The area under the ROC curve of the initial TG measurements in the non-fasting population was not inferior to that of the multivariate model where other non-fasting health checkup data were added. The optimal non-fasting TG cutoff point was 2.0 mmol/l. The cutoff point was further lowered when the population was limited to patients undergoing health checkups four or more hours after their last meal and when the prevalence of hypertriglyceridemia in the population was simulated to be reduced. Conclusions: The non-fasting workplace TG measurements by themselves exhibited a tolerable performance for predicting hypertriglyceridemia. The optimal cutoff point in Japanese employees appears to be lower than 2.3 mmol/l, the recently proposed Western cutoff point. J Atheroscler Thromb, 2013; 20:661-669.

Determination of optimal cut-off points after a high-fat meal corresponding to fasting elevations of triglyceride and remnant cholesterol in Chinese subjects

“…Until now, similar expert consensus or study is still rare in China. Recently, we determined a cut-off point for non-fasting TG level 2.02 mmol/L at 4 h after a daily breakfast in relation to fasting TG ≥ 1.7 mmol/L in 109 Chinese subjects with and without overweight [10], which is very close to the values recommended by the European joint consensus statement or reported by other scholars [6, 8, 9]. HTG indicates the increases in circulating triglyceride-rich lipoproteins (TRLs) and their remnants, remnant lipoproteins [4, 11, 12].…”

“…According to the European joint consensus statement from the European Atherosclerosis Society (EAS) and the statement from the American Heart Association (AHA), non-fasting TG levels in patients whose fasting TG < 1.7 mmol/L would not be expected to raise above 2.0 mmol/L (175 mg/dL) and 2.26 mmol/L (200 mg/dL), respectively, after consuming a daily low fat meal before blood sampling [6, 7]. However, the cut-off point to diagnose non-fasting HTG is 1.98 mmol/L (175 mg/dL) in middle aged and older apparently healthy American women basing on the Women’s Health Study [8], which is very close to the optimal non-fasting TG cut-off point (2.0 mmol/L) in Japanese employees [9]. Until now, similar expert consensus or study is still rare in China.…”

Lipid Accumulation Product and Hypertension Related to Stroke: a 9.2-Year Prospective Study Among Mongolians in China

“…pressure measurements, WC, and TG concentration were recorded only once at baseline, and we have no data on possible changes in blood pressure and LAP during the follow-up. Secondly, there is evidence that lipid overaccumulation, such as increased WC and elevated TG level, has different importance in women and men in terms of cardiovascular risk [40][41][42][43] ; it is better to perform an analysis in stratifying participants by gender. We did not stratify participants by gender because of our comparatively small sample size and the relatively low number of strokes, but we adjusted gender as an important confounding variable in multivariable analysis.…”

Predictive impact of adiponectin for detecting dysglycemia in non-fasting Japanese employees with metabolic risk factors

“…We therefore adopted these components as inclusion criteria in the current study. We used 2.3 mmol/L (200 mg/dL) as a cutoff point of postprandial triglycerides levels [10] , providing a high specificity for hypertriglyceridemia defined by fasting triglycerides levels ≥ 1.7 mmol/L (150 mg/dL) [20]. We also adopted elevated alanine aminotransferase levels as an inclusion criterion, because alanine aminotransferase is known to be a marker of non-alcoholic fatty liver disease, which is associated with insulin resistance and diabetes mellitus [11][12][13].…”