Arteriosclerosis and Thrombosis, Vol 11, 2-14, Copyright © 1991 by American Heart Association

ARTICLES

Plasma triglyceride and coronary heart disease

MA Austin
Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle 98195.

Although the literature on epidemiological associations between plasma triglyceride and CHD is not completely consistent, trends do emerge from the studies described here. First, the majority of observational studies demonstrate a significant univariate relation, although the results of case-control and cross-sectional studies are more uniform than those from prospective study designs. In many but not all studies, triglyceride remains a significant predictor of CHD in multivariate statistical analyses after controlling for TC or LDL-C. Perhaps the least consistent result is that the triglyceride association does not persist in some analyses controlling for HDL-C, while in other studies, the association remains significant. Although most studies have been conducted in men, the studies providing data on women, normocholesterolemic subjects, and diabetic subjects have generally found triglyceride to be, at the very least, a univariate risk factor. The results of intervention trials differ considerably, but no such study to date has been specifically designed to evaluate triglyceride- lowering effects on primary prevention of CHD. Important statistical properties must be taken into consideration in evaluating triglyceride as a risk factor for CHD. The large variability of triglyceride measurements and the correlation of triglyceride values with other lipid measures appears to result in the underestimation of the association between triglyceride and disease in multivariate analyses. Finally, individual genetic susceptibility may play an important role in the relation between plasma triglyceride levels and CHD. For example, risk of CHD clearly varies among the well-established familial forms of hypertriglyceridemia. A predominance of small, dense, LDL particles (LDL subclass pattern B) also appears to be a genetic trait associated with both increased risk of MI and increases in plasma triglyceride levels.

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				J. Jeppesen, H. O. Hein, P. Suadicani, and F. Gyntelberg Relation of High TG–Low HDL Cholesterol and LDL Cholesterol to the Incidence of Ischemic Heart Disease: An 8-Year Follow-up in the Copenhagen Male Study Arterioscler Thromb Vasc Biol, June 1, 1997; 17(6): 1114 - 1120. [Abstract] [Full Text]

				F. Tato, G. L. Vega, and S. M. Grundy Determinants of Plasma HDL-Cholesterol in Hypertriglyceridemic Patients: Role of Cholesterol-Ester Transfer Protein and Lecithin Cholesteryl Acyl Transferase Arterioscler Thromb Vasc Biol, January 1, 1997; 17(1): 56 - 63. [Abstract] [Full Text]

				M. J. Stampfer, R. M. Krauss, J. Ma, P. J. Blanche, L. G. Holl, F. M. Sacks, and C. H. Hennekens A Prospective Study of Triglyceride Level, Low-Density Lipoprotein Particle Diameter, and Risk of Myocardial Infarction JAMA, September 18, 1996; 276(11): 882 - 888. [Abstract] [PDF]

				M.-F. Hau, A. H.M. Smelt, A. J.G.H. Bindels, E. J.G. Sijbrands, A. Van der Laarse, W. Onkenhout, W. van Duyvenvoorde, and H. M.G. Princen Effects of Fish Oil on Oxidation Resistance of VLDL in Hypertriglyceridemic Patients Arterioscler Thromb Vasc Biol, September 1, 1996; 16(9): 1197 - 1202. [Abstract] [Full Text]

				R. G. Bakker-Arkema, M. H. Davidson, R. J. Goldstein, J. Davignon, J. L. Isaacsohn, S. R. Weiss, L. M. Keilson, W. V. Brown, V. T. Miller, L. J. Shurzinske, et al. Efficacy and Safety of a New HMG-CoA Reductase Inhibitor, Atorvastatin, in Patients With Hypertriglyceridemia JAMA, January 10, 1996; 275(2): 128 - 133. [Abstract] [PDF]

				H. N. Ginsberg, J. Jones, W. S. Blaner, A. Thomas, W. Karmally, L. Fields, D. Blood, and M. D. Begg Association of Postprandial Triglyceride and Retinyl Palmitate Responses With Newly Diagnosed Exercise-Induced Myocardial Ischemia in Middle-Aged Men and Women Arterioscler Thromb Vasc Biol, November 1, 1995; 15(11): 1829 - 1838. [Abstract] [Full Text]

				C. Gerdes, L. U. Gerdes, P. S. Hansen, and O. Faergeman Polymorphisms in the Lipoprotein Lipase Gene and Their Associations With Plasma Lipid Concentrations in 40-Year-Old Danish Men Circulation, October 1, 1995; 92(7): 1765 - 1769. [Abstract] [Full Text]

				C. M. Burchfiel, A. Laws, R. Benfante, R. J. Goldberg, L.-J. Hwang, D. Chiu, B. L. Rodriguez, J. D. Curb, and D. S. Sharp Combined Effects of HDL Cholesterol, Triglyceride, and Total Cholesterol Concentrations on 18-Year Risk of Atherosclerotic Disease Circulation, September 15, 1995; 92(6): 1430 - 1436. [Abstract] [Full Text]

				J. Levenson, P. Giral, M. Razavian, J. Gariepy, and A. Simon Fibrinogen and Silent Atherosclerosis in Subjects With Cardiovascular Risk Factors Arterioscler Thromb Vasc Biol, September 1, 1995; 15(9): 1263 - 1268. [Abstract] [Full Text]

				T. Katsuya, M. Horiuchi, Y.-D. I. Chen, G. Koike, R. E. Pratt, V. J. Dzau, and G. M. Reaven Relations Between Deletion Polymorphism of the Angiotensin-Converting Enzyme Gene and Insulin Resistance, Glucose Intolerance, Hyperinsulinemia, and Dyslipidemia Arterioscler Thromb Vasc Biol, June 1, 1995; 15(6): 779 - 782. [Abstract] [Full Text]

				T. Coleman, R. L. Seip, J. M. Gimble, D. Lee, N. Maeda, and C. F. Semenkovich COOH-terminal Disruption of Lipoprotein Lipase in Mice Is Lethal in Homozygotes, but Heterozygotes Have Elevated Triglycerides and Impaired Enzyme Activity J. Biol. Chem., May 26, 1995; 270(21): 12518 - 12525. [Abstract] [Full Text] [PDF]

				B. G. Nordestgaard, R. Wootton, and B. Lewis Selective Retention of VLDL, IDL, and LDL in the Arterial Intima of Genetically Hyperlipidemic Rabbits In Vivo : Molecular Size as a Determinant of Fractional Loss From the Intima–Inner Media Arterioscler Thromb Vasc Biol, April 1, 1995; 15(4): 534 - 542. [Abstract] [Full Text]

				J. Jeppesen, C. B. Hollenbeck, M.-Y. Zhou, A. M. Coulston, C. Jones, Y.-D. I. Chen, and G. M. Reaven Relation Between Insulin Resistance, Hyperinsulinemia, Postheparin Plasma Lipoprotein Lipase Activity, and Postprandial Lipemia Arterioscler Thromb Vasc Biol, March 1, 1995; 15(3): 320 - 324. [Abstract] [Full Text]

				F. Karpe, M. Bell, J. Bjorkegren, and A. Hamsten Quantification of Postprandial Triglyceride-Rich Lipoproteins in Healthy Men by Retinyl Ester Labeling and Simultaneous Measurement of Apolipoproteins B-48 and B-100 Arterioscler Thromb Vasc Biol, February 1, 1995; 15(2): 199 - 207. [Abstract] [Full Text]

				M. Dammerman and J. L. Breslow Genetic Basis of Lipoprotein Disorders Circulation, January 15, 1995; 91(2): 505 - 512. [Full Text]

				A M Garber and A L Avins Triglyceride concentration and coronary heart disease BMJ, July 2, 1994; 309(6946): 2 - 3. [Full Text]

				M. E. Marenberg, N. Risch, L. F. Berkman, B. Floderus, and U. de Faire Genetic Susceptibility to Death from Coronary Heart Disease in a Study of Twins N. Engl. J. Med., April 14, 1994; 330(15): 1041 - 1046. [Abstract] [Full Text]

				M. A. Denke, C. T. Sempos, and S. M. Grundy Excess Body Weight: An Under-recognized Contributor to Dyslipidemia in White American Women Arch Intern Med, February 28, 1994; 154(4): 401 - 410. [Abstract] [PDF]

				M. Farnier, F. Bonnefous, N. Debbas, and A. Irvine Comparative Efficacy and Safety of Micronized Fenofibrate and Simvastatin in Patients With Primary Type Ha or IIb Hyperlipidemia Arch Intern Med, February 28, 1994; 154(4): 441 - 449. [Abstract] [PDF]

				D. Ornish, S. E. Brown, B. A. Kottke, S. Shea, J. D. Barth, G. K. Bryan, J. E. Hokanson, M. A. Austin, H. N. Ginsberg, A. R. Tall, et al. Treatment of and Screening for Hyperlipidemia N. Engl. J. Med., October 7, 1993; 329(15): 1124 - 1128. [Full Text]

				J. I. T. Isojarvi, A. J. Pakarinen, and V. V. Myllyla Serum Lipid Levels During Carbamazepine Medication: A Prospective Study Arch Neurol, June 1, 1993; 50(6): 590 - 593. [Abstract] [PDF]

				M. A. Denke, C. T. Sempos, and S. M. Grundy Excess Body Weight: An Underrecognized Contributor to High Blood Cholesterol Levels in White American Men Arch Intern Med, May 10, 1993; 153(9): 1093 - 1103. [Abstract] [PDF]

				S. M. Grundy and G. L. Vega Two Different Views of the Relationship of Hypertriglyceridemia to Coronary Heart Disease: Implications for Treatment Arch Intern Med, January 1, 1992; 152(1): 28 - 34. [Abstract] [PDF]