High TG, Low HDL-C Levels May Help Further Stratify CHD Risk
Fasting high TG + low HDL associated with increased risk, particularly in those with diabetes
FRIDAY, Feb. 3, 2017 (HealthDay News) -- A high fasting triglyceride (TG) level combined with a low high-density lipoprotein cholesterol (HDL-C) level is associated with increased risks of incident coronary heart disease (CHD) and ischemic stroke, especially for patients with diabetes or a low-density lipoprotein cholesterol (LDL-C) level of ≥130 mg/dL, independent of other atherosclerotic cardiovascular disease risk factors, according to a study published online Jan. 25 in Diabetes Care.
Jennifer S. Lee, M.D., from the Stanford University Medical Center in California, and colleagues studied 3,216 American Indians (41 percent with diabetes) who were free from cardiovascular disease at baseline in a prospective cohort (median follow-up 17.7 years). The authors estimated hazard ratios (HRs) for incident ischemic stroke and coronary heart disease in relation to combined TG and HDL-C status (fasting TG level ≥150 mg/dL was high; fasting HDL-C level <40 mg/dL [for men] was low).
The researchers found that, compared to those with normal TG and HDL levels, participants with high TG and low HDL levels had a 1.32-fold elevated HR for CHD. In participants with, but not those without, diabetes, high TG plus low HDL levels correlated with a 1.54- and 2.13-fold increased HR for CHD and stroke, respectively (P value for interaction = 0.003 and 0.060, respectively). In participants with LDL-C levels of ≥130 mg/dL, high TG and low HDL correlated with CHD risk; this was not seen in participants with lower LDL-C levels. The correlations were not modified by sex.
"Adults with both high TG and low HDL-C, particularly those with diabetes, have increased risks of incident CHD and stroke," the authors write. "Recognition of these patterns may help to enhance lipid-targeted strategies to prevent CHD and ischemic stroke."