Relation of High TG–Low HDL Cholesterol and LDL Cholesterol to the Incidence of Ischemic Heart Disease

Abstract

High triglyceride (TG) and low HDL cholesterol (HDL-C) is the characteristic dyslipidemia seen in insulin-resistant subjects. We examined the role of this dyslipidemia as a risk factor of ischemic heart disease (IHD) compared with that of high LDL cholesterol (LDL-C) in the Copenhagen Male Study. In total 2910 white men, aged 53 to 74 years, free of cardiovascular disease at baseline, were subdivided into four groups on the basis of fasting concentrations of serum TG, HDL-C, and LDL-C. "High TG-low HDL-C" was defined as belonging to both the highest third of TG and the lowest third of HDL-C; this group encompassed one fifth of the population. "High LDL-C" was defined as belonging to the highest fifth of LDL-C. A control group was defined as not belonging to either of these two groups. "Combined dyslipidemia" was defined as belonging to both dyslipidemic groups. Age-adjusted incidence of IHD during 8 years of follow-up was 11.4% in high TG-low HDL-C, 8.2% in high LDL-C, 6.6% in the control group, and 17.5% in combined dyslipidemia. Compared with the control group, relative risks of IHD (95% confidence interval), adjusted for potentially confounding factors or covariates (age, body mass index, alcohol consumption, physical activity, non-insulin-dependent diabetes, hypertension, smoking, and social class), were 1.5 (1.0-2.1), P < .05; 1.3 (0.9-2.0), P = .16; and 2.4 (1.5-4.0), P < .01, in the three dyslipidemic groups, respectively. In conclusion, the present results showed that high TG-low HDL-C, the characteristic dyslipidemia seen in insulin-resistant subjects, was at least as powerful a predictor of IHD as isolated high LDL-C. The results suggest that efforts to prevent IHD should include intervention against high TG-low HDL-C, and not just against hypercholesterolemia.

Role of Gender in the Prevalence of Metabolic Syndrome and Its Related Risk Factors in Shiraz Healthy Heart Center Population

“…Additionally, transfer of TG from TG-rich lipoproteins to HDL-c is done using this enzyme in exchange for cholesteryl esters, and that's why a negative correlation between these two variables can be found according to CETP activity (26). HDL-c and TG are considered important risk factors for CVD (27,28) and these correlations can be important. Moreover, BMI and waist circumference are considered the markers of adiposity.…”

Life Style and Cardiovascular Risk Factors in the Japanese Population-From an Epidemiological Survey on Serum Lipid Levels in Japan 1990. Part 1: Influence of Life Style and Excess Body Weight on HDL-Cholesterol and Other Lipid Parameters in Men

“…a Quintile ranges for general population of men aged 20-39 are used Statistical significance levels : * p < 0.05, * * p < 0.01, * * * p < 0.001 vs non-drinkers procedure for HDL-C was standardized more easily than that for TG, HDL-C had long been used as a parameter taking the place of TG in practice in the lipid clinic, while the use of TG in judging the appropriateness of the treatment of hyperlipidemia has long been ignored in epidemiological studies (23). Since evidence has accumulated over the past ten years showing the importance of TG as an independent risk factor in CAD (24)(25)(26)(27), it seems necessary to reexamine the change in lipid parameters with respect to life style in a population-based epidemiological study and to reevaluate the significance of HDL-C and TG as possible risk factors in CAD. It is well known that obesity and serum TG are the most important factors in the decrease of HDL-C (13-16).…”

“…Meta-analysis of the epidemiological data (43,44), in addition to the data obtained in clinical studies (25)(26)(27) have shown that TG is an independent cardiovascular risk factor. A report from the PROCAM study also showed that high triglyceride was a risk even in a population with high HDL-C (45).…”

“…However, recent reports from the United States and Europe have shown that serum TG levels are independent risk factors (25)(26)(27), and TG values above 150 mg/dl were mentioned as a component of multiple risk factor syndrome in the latest version of the Guidelines of the National Cholesterol Education Program in the United States of America (28). In Japan, the importance of mild to moderate dyslipidemia with an increase in TG levels in the form of intermediate density lipoproteins (IDL) and a decrease in HDL-C associated with glucose intolerance or diabetes mellitus has long been recognized as a risk factor syndrome in CAD (29)(30)(31).…”

Life Style and Cardiovascular Risk Factors in the Japanese Population-From an Epidemiological Survey on Serum Lipid Levels in Japan 1990. Part 2: Association of Lipid Parameters with Hypertension

“…Because TG values fluctuate markedly after meals and [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] the assay procedure for HDL-C was standardized more easily than that for TG, HDL-C has long been used as a parameter, taking the place of TG in practice in the clinic and the use of TG in judging the appropriateness of the treatment of hyperlipidemia has long been ignored in epidemiological studies (25). However, meta-analysis of epidemiological data (26,27) has shown that TG is an independent cardiovascular risk factor and evidence has accumulated over the past ten years showing the importance of TG as an independent risk factor in CAD (28)(29)(30).…”