Ancestry should be considered when using triglycerides as cardiometabolic biomarker
Click Here to Manage Email Alerts
Key takeaways:
- Triglyceride levels vary substantially among people from West African, East African and European ancestries.
- Other lipid markers were similar across ancestries.
Data from four large studies with ancestry data show there are “clear differences” in associations between triglyceride levels with known cardiometabolic risk factors for people from West African, East African and European backgrounds.
The analysis of data from more than 32,000 people from sub-Saharan Africa, Europe and the U.S. suggest such ancestral differences should be considered when evaluating the value of triglyceride levels as a marker for cardiometabolic health, including risk for hypertension and type 2 diabetes.
Image: Adobe Stock
“Triglyceride levels are among the most commonly ordered clinical laboratory tests as a risk biomarker for atherosclerosis, heart disease, stroke and metabolic disorders,” Karlijn Meeks, PhD, MSc, a research fellow at the Center for Research on Genomics and Global Health at the NIH, told Healio. “Our findings suggest that triglycerides may not be an equally strong biomarker for various cardiometabolic risk factors in West and East Africans as it is in European populations.”
Meeks and colleagues analyzed data from four cross-sectional studies: the Africa America Diabetes Mellitus study, the Research on Obesity and Diabetes among African Migrants study, the Healthy Life in an Urban Setting study, and National Health and Nutrition Examination Survey. The studies included participants with West African ancestry from sub-Saharan Africa (n = 7,201), the U.S. (n = 4,390) and Europe (n = 6,436), as well as participants with East African ancestry from sub-Saharan Africa (n = 781), and people with European ancestry from U.S. (n = 8,670) and from Europe (n = 4,541).
“We separated West African ancestry from East African ancestry to assess whether the relationship between triglycerides and cardiometabolic disorders and risk factors differs across African-ancestry populations,” the researchers wrote.
Researchers used linear regression analyses to assess the association between triglycerides and cardiometabolic risk factors.
The findings were published in eBioMedicine.
The median triglyceride level was substantially higher among urban East Africans (median, 1.6 mmol/L) compared with all other populations. The lowest median triglyceride level was observed among West African migrants (median, 0.62 mmol/L). However, other major lipid measurements including total cholesterol, HDL and LDL were similar across ancestries.
Researchers observed higher adjusted regression coefficients in the relationship between triglycerides and hypertension for participants with European ancestry (beta = 0.179; 95% CI, 0.156- 0.203) compared with those with West African ancestry (beta = 0.102; 95% CI, 0.086-0.118). Similarly, researchers found higher adjusted regression coefficients in the relationship between triglycerides and BMI for participants with European ancestry (beta = 0.028; 95% CI, 0.027-03) compared with those with West African ancestry (beta = 0.015; 95% CI, 0.014-016), as well as for the relationship between triglycerides and waist circumference, with a P < .05 for all ancestry and trait interactions. Results persisted with factoring in environmental differences within ancestry groups. The researchers noted there was less consistency among people of East African ancestry.
The associations between triglycerides and type 2 diabetes did not follow ancestry patterns.
“If confirmed by other studies, the value of measuring triglyceride levels in the clinic with the goal of identifying individuals at high risk for developing cardiometabolic disorders needs to be re-evaluated for African ancestry populations,” Meeks told Healio. “Population specific guidelines for risk stratification may be needed to minimize misclassification due to using a single cut-off across all populations.”
Meeks said more research is needed to better understand the value of triglyceride levels in assessing cardiometabolic risk among diverse populations.
“We need to gain more insight in the predictive value of triglycerides by means of longitudinal study designs,” Meeks told Healio. “Our study focused on African ancestry populations, but other understudied populations need to be studied as well, as it is possible that they may also differ in their triglycerides risk associations. Additionally, there need to be studies focused on understanding the underlying biology and we have ongoing work with that aim.”
For more information:
Karlijn Meeks, PhD, MSc, can be reached at karlijn.meeks@nih.gov; Twitter: @genome_gov.
Collapse
Click Here to Manage Email Alerts