Abstract
Background"Hypertriglyceridemic waist" (HTGW) phenotype, an inexpensive early screening tool for detection of individuals at risk for type 2 diabetes and cardiovascular disease was found to be associated with subclinical atherosclerosis in various patient populations such as those with diabetes mellitus, chronic kidney disease, and those infected with human immunodeficiency virus. However, less is known regarding an association between HTGW and subclinical atherosclerosis in the apparently healthy, multiethnic population. Therefore, the aim of the study was to explore the association between HTGW and sub-clinical atherosclerosis in an apparently healthy, multiethnic population; and to investigate whether the effect of HTGW on sub-clinical atherosclerosis persists over and above the traditional atherosclerosis risk factors.MethodsWe studied 809 individuals of Aboriginal, Chinese, European and South Asian origin who were assessed for indices of sub-clinical atherosclerosis (intima-media thickness (IMT), total area and presence of carotid plaques), socio-demographic and lifestyle characteristics, anthropometrics, lipids, glucose, blood pressure, and family history of cardiovascular disease.ResultsWe found that, compared to individuals without HTGW and after adjusting for age, ethnicity, smoking, and physical activity; men and women with HTGW had a significantly higher: IMT (men: B (95%CI = 0.084 (0.037, 1.133), p < 0.001; women: B (95%CI) = 0.041 (0.006, 0.077), p = 0.020); and total area (men: B (95%CI = 0.202 (0.058, 0.366), p = 0.005; women: B (95%CI) = 0.115 (0.006, 0.235), p = 0.037). The association between HTGW waist and presence of plaques was significant for men (OR (95%CI) = 1.904 (1.040, 3.486), p = 0.037 vs. men without HTGW), but not for women (p = 0.284). Once analyses were adjusted for additional, traditional risk factors for atherosclerosis, the effect of HTGW on sub-clinical atherosclerosis was no longer significant.ConclusionsIn conclusion, HTGW may serve as an early marker of subclinical atherosclerosis in men and women, irrespective of ethnicity. However, once individuals are assessed for all traditional risk factors for atherosclerosis, the additional assessment for HTGW is not warranted.
Highlights
Atherosclerosis is a chronic progressive disease associated with high cardiovascular morbidity and mortality [1]
In conclusion, in a multi-ethnic population of apparently healthy individuals, in both men and women, the presence of hypertriglyceridemic waist (HTGW) was positively associated with subclinical atherosclerosis as depicted by carotid Intima-media thickness (IMT) and total area indices after adjustment for age, ethnicity, smoking and physical activity
In our study, HTGW did not show the association with subclinical atherosclerosis over and above the traditional risk factors for atherosclerosis
Summary
Atherosclerosis is a chronic progressive disease associated with high cardiovascular morbidity and mortality [1]. The diagnosis of atherosclerosis in its subclinical stage (subclinical atherosclerosis) is important, as it would allow for early implementation of lifestyle prevention programs that may help prevent further progression and cardiovascular events [2]. Various invasive and non-invasive arterial imaging techniques (such as intravascular sonography, B-mode ultrasonography, computed tomography and magnetic imaging) have been developed to detect and diagnose sub-clinical atherosclerosis [1]. A commonly used technique is a non-invasive B-mode ultrasonography that can determine the thickness of the intima-media layers (intima-media thickness, IMT) and characterize focal plaques. IMT carotid ultrasound is an established non-invasive method for detection of early atherosclerotic disease [3]. Longitudinal studies have shown a strong association between IMT and future risk of myocardial infarction and stroke [3,4], while in clinical trials IMT is often used to evaluate the effects of coronary heart disease risk factor interventions on atherosclerotic burden [5]
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