No association non-fasting triglycerides with subclinical atherosclerosis
Association of fasting triglyceride concentration and postprandial triglyceride response with the carotid intima media thickness in the middle aged: the NEO studyLiterature - Christen T, de Mutsert R, Gast KB, et al. - J Clin Lipidol, 2017, In press
- Mean fasting TGc was 1.21 mmol/L (SD 0.82) and mean TG response was 29.8 mmol/L*min (SD 24.0). Correlation coefficient of fasting TGc with TGc after 150 min was 0.92.
- Per SD of fasting TGc, the crude difference in IMT was 18.8 µm (95% CI 13.4-24.1) and after adjustment for age, sex and TGiAUC (TG incremental area under the curve) was 14.4 µm (95% CI 8.9-20.0). Further adjustment for all confounding factors attenuated this to 8.5 µm (95% CI 2.1-14.9).
- Per SD of TGiAUC, the crude difference in IMT was 13.2 µm (95% CI 7.0-19.4). Adjustment for age, sex and fasting TGc attenuated this to 2.7 µm (95% CI -3.6-9.0) and for all confounding factors resulted in loss of association (-1.7 µm, 95% CI -8.5-5.0).
- Association postprandial TG response and carotid IMT in high-risk subgroups; crude and after adjustment of all confounding factors were respectively for men 5.6 µm (95% CI -4.4-15.5) and -0.3 µm (95% CI -10.3-9.6), women 12.3 µm (95% CI 4.5-20.1) and -1.3 µm (95% CI -10.1-7.5), individuals with normal fasting glucose concentrations 12.0 µm (95% CI 5.0-19.0) and -2.3 µm (95% CI -10.0-6.5), impaired fasting glucose concentrations 8.1 µm (95% CI -4.2-20.5) and 3.2 µm (95% CI -8.9-15.3), never smokers 15.8 µm (95% CI 6.0-25.5) and 0.8 µm (95% CI -10.0-11.6), former smokers 8.3 µm (95% CI -0.1-16.7) and -6.6 µm (95% CI -15.5-2.2), current smoker 14.8 µm (95% CI -1.8-31.3) and 7.7 µm (95% CI -8.5-23.9).
There was a clear association between fasting TGc and IMT, which persisted after adjustment for postprandial TG response over 150 minutes. However, the association observed between crude TG response after a meal and IMT disappeared after adjusting for fasting TGc. These results imply that non-fasting and fasting TGc may not be exchangeable and that it may not be useful to perform a meal challenge in order to estimate a person’s risk of atherosclerosis. The association between TG response and IMT remained in smokers and pre-diabetics/diabetics after adjustment for fasting TGc, which may indicate that these conditions increase the susceptibility of the endothelial wall to either postprandial TG response or higher concentrations of remnant particles.