Non-fasting triglycerides ≥5 mmol/L versus <1 mmol/L marked a 17-fold and 5-fold increased risk of myocardial infarction in women and men in the general population.
Do elevated non-fasting triglycerides and remnant cholesterol increase the risk of cardiovascular disease and early death in the general population?
Elevated non-fasting triglycerides and remnant cholesterol are highly prevalent in the general population and strongly associated with increased risk of myocardial infarction, ischemic stroke, and early death.
Estimación del efecto: 17-fold (women) and 5-fold (men) increased risk
Non-fasting triglycerides are measured at any time within up to 8 h (14 h) after any normal meal, while postprandial triglycerides are measured at a fixed time point within up to 8 h (14 h) of a standardised fat tolerance test. The simplest possible way of evaluating remnant cholesterol is non-fasting/postprandial total cholesterol minus low-density lipoprotein (LDL) cholesterol minus high-density lipoprotein (HDL) cholesterol. Elevated levels of non-fasting/postprandial triglycerides directly correlate with elevated remnant cholesterol. In the general population, 38% of men have non-fasting/postprandial triglycerides > 2mmol/L (>176 mg/dL) while 45% of men have non-fasting/postprandial triglyceride levels of 1-2 mmol/L (89-176 mg/dL); corresponding fractions in women are 20% and 47%. Also, 31% of men have remnant cholesterol levels > 1mmol/L (>39 mg/dL) while 46% of men have remnant cholesterol levels of 0.5-1 mmol/L (19-39 mg/dL); corresponding fractions in women are 15% and 43%. Non-fasting triglycerides ≥5 mmol/L vs. <1 mmol/L marked a 17 and 5 fold increased risk of myocardial infarction, a 5 and 3 fold increased risk of ischemic stroke, and a 4 and 2 fold increased risk of early death in women and men in the general population. As all cells can degrade triglycerides it is biologically unlikely that it is the triglyceride molecules themselves that cause atherosclerosis and cardiovascular disease. However, elevated remnant cholesterol may lead to cholesterol entrapment in the arterial intima and consequently to accelerated atherosclerosis and cardiovascular disease.
Nordestgaard et al. (Mon,) conducted a review in Hypertriglyceridemia. Elevated non-fasting triglycerides (≥5 mmol/L) vs. <1 mmol/L was evaluated on Myocardial infarction (17-fold (women) and 5-fold (men) increased risk). Non-fasting triglycerides ≥5 mmol/L versus <1 mmol/L marked a 17-fold and 5-fold increased risk of myocardial infarction in women and men in the general population.