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CV events common with large triglyceride to HDL ratio
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Chinese adults with triglyceride to HDL cholesterol ratios greater than 0.8533 are more likely to experience a stroke, myocardial infarction or overall cardiovascular event than those with smaller ratios, according to findings published in the Journal of Diabetes Investigation.
“Compared with other individual lipid profiles, the [triglyceride to HDL cholesterol] ratio can be a better predictive indicator for insulin resistance, obesity and coronary heart disease by reflecting the complex interactions of lipoprotein metabolism,” Shouling Wu, MD, PhD, of the department of cardiology at Kailuan Hospital and North China University of Science and Technology in Tangshan, China, and colleagues wrote. “Although some studies have shown the relationship between the [triglyceride to HDL cholesterol] ratio and CV events, cohort studies regarding this correlation have been rarely reported, especially in the Chinese population.”
Using a prospective study design, Wu and colleagues recruited 96,542 participants (mean age, 51.5 years; 20.4% women) from Kailuan General Hospital to assess triglyceride to HDL cholesterol ratio and its effects on CV outcomes. The researchers collected blood samples between 2006 and 2007 and measured HDL cholesterol, fasting plasma glucose, total cholesterol, triglycerides, LDL cholesterol and high-sensitivity C-reactive protein. CV events were self-reported and identified in medical and insurance records, according to the researchers, who noted that participants were followed for an average of 9.75 years.
Researchers found a median triglyceride to HDL cholesterol ratio of 0.8533 among the cohort. Those with a ratio greater than this mark were considered to have a high ratio, and those with a ratio less than the mark were considered to have a low ratio.
In the total study cohort, a major CV event took place 5,422 times in the decade after study initiation. The researchers identified 3,115 such events in participants with a high triglyceride to HDL cholesterol ratio, making for a cumulative incidence of 3.23, and 2,307 events in those with low ratios, which equated to a cumulative incidence of 2.39 (P < .001). A CV event was 1.19 times more likely to occur for a participant with a high ratio vs. a participant with a low ratio (OR = 1.19; 95% CI, 1.12-1.26).
Of the 4,228 strokes that occurred across the duration of the study, 2,372 occurred in those with a high ratio and 1,856 occurred in those with a low ratio. When comparing cumulative incidence of stroke between the two groups, those with high ratios had an increased rate vs. those with low ratios (2.46 vs. 1.92; P < .001). In addition, participants with a high ratio were 1.11 times more likely to experience a stroke than those with a low ratio (OR = 1.11; 95% CI, 1.03-1.18).
The researchers also observed 1,312 MIs in the total study cohort, including 819 for those with high ratios and 493 for those with low ratios. A cumulative incidence rate of 0.85 was reported for those with high ratios vs. a rate of 0.51 for those with low ratios (P < .001). Such an event was 1.5 times more likely to occur for a participant with a higher ratio compared with a participant with a lower ratio (OR = 1.5; 95% CI, 1.33-1.7).
“Among the general population, the [triglyceride to HDL cholesterol] ratio should be used for risk-stratification and be considered as a significant index for adverse reactions in the long term,” the researchers wrote. “The present results might help the public policymakers to formulate a strategy for individuals at high risk of major CV events in the Chinese population.” – by Phil Neuffer
Disclosures: The authors report no relevant financial disclosures.
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