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Fasting triglycerides are positively associated with cardiovascular mortality risk in people with diabetes
Cardiovascular Research ( IF 10.8 ) Pub Date : 2022-07-29 , DOI: 10.1093/cvr/cvac124
Yutang Wang 1 , Yan Fang 1 , Dianna J Magliano 2 , Fadi J Charchar 1 , Christopher G Sobey 3 , Grant R Drummond 3 , Jonathan Golledge 4, 5
Affiliation  

Aims We investigated the association of fasting triglycerides with cardiovascular disease (CVD) mortality. Methods and results This cohort study included US adults from the National Health and Nutrition Examination Surveys from 1988 to 2014. CVD mortality outcomes were ascertained by linkage to the National Death Index records. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of triglycerides for CVD mortality. The cohort included 26,570 adult participants, among which 3,978 had diabetes. People with higher triglycerides had a higher prevalence of diabetes at baseline. The cohort was followed up for a mean of 12.0 years with 1,492 CVD deaths recorded. A 1-natural-log-unit higher triglyceride was associated with a 30% higher multivariate-adjusted risk of CVD mortality in participants with diabetes (HR, 1.30; 95% CI, 1.08-1.56) but not in those without diabetes (HR, 0.95; 95% CI, 0.83-1.07). In participants with diabetes, people with high triglycerides (200-499 mg/dL) had a 44% (HR, 1.44; 95% CI, 1.12-1.85) higher multivariate-adjusted risk of CVD mortality compared with those with normal triglycerides (<150 mg/dL). The findings remained significant when diabetes was defined by fasting glucose levels alone, or after further adjustment for the use of lipid-lowering medications, or after the exclusion of those who took lipid-lowering medications. Conclusions This study demonstrates that fasting triglycerides of ≥200 mg/dl are associated with an increased risk of CVD mortality in patients with diabetes but not in those without diabetes. Future clinical trials of new treatments to lower triglycerides should focus on patients with diabetes.

中文翻译:

空腹甘油三酯与糖尿病患者的心血管死亡风险呈正相关

目的 我们调查了空腹甘油三酯与心血管疾病 (CVD) 死亡率的关系。方法和结果 这项队列研究纳入了 1988 年至 2014 年国家健康和营养检查调查中的美国成年人。CVD 死亡率结果是通过与国家死亡指数记录的联系来确定的。Cox 比例风险模型用于估算甘油三酯对 CVD 死亡率的风险比 (HR) 和 95% 置信区间 (CI)。该队列包括 26,570 名成人参与者,其中 3,978 名患有糖尿病。甘油三酯较高的人在基线时糖尿病患病率较高。该队列平均随访 12.0 年,记录了 1,492 例 CVD 死亡病例。高 1 个自然对数单位的甘油三酯与糖尿病参与者的 CVD 死亡率高 30% 的多变量调整风险相关(HR,1.30;95% CI,1.08-1.56),但与非糖尿病参与者无关(HR, 0.95;95% CI,0.83-1.07)。在患有糖尿病的参与者中,高甘油三酯 (200-499 mg/dL) 的人与正常甘油三酯的人相比,多变量调整后的 CVD 死亡率风险高 44% (HR, 1.44; 95% CI, 1.12-1.85) (< ;150 毫克/分升)。当仅通过空腹血糖水平定义糖尿病时,或在进一步调整降脂药物的使用后,或在排除服用降脂药物的人后,这些发现仍然很重要。结论 本研究表明,≥ 200 mg/dl 的空腹甘油三酯与糖尿病患者的 CVD 死亡风险增加有关,但与非糖尿病患者无关。未来降低甘油三酯新疗法的临床试验应侧重于糖尿病患者。
更新日期:2022-07-29
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