Triglyceride levels and risk of cardiovascular disease and all-cause mortality in Chinese adults younger than 40 years old: a prospective cohort study.

IF 2.1 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Cardiovascular diagnosis and therapy Pub Date : 2024-04-30 Epub Date: 2024-03-29 DOI:10.21037/cdt-23-412

Zhaogui Wu, Jingli Gao, Shuohua Chen, Guodong Wang, Hangkuan Liu, Xuezhu Wang, Pengfei Sun, Xuefang Yu, Qing Yang, Shouling Wu, Xin Zhou

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Abstract

Background: Data on the associations of triglyceride (TG) levels with cardiovascular disease (CVD) and all-cause mortality mainly focused on the middle-aged or elderly population, with limited information available for younger adults. This study aimed to identify such associations among Chinese young adults.

Methods: This study included Chinese adults younger than 40 years free of CVD, cancer, and lipid-lowering agents at baseline in the Kailuan study who were enrolled during 2006 through 2016. All participants were biennially followed up till December 2020. The enzymatic colorimetric method was used to measure baseline fasting TG. Participants were categorized into four groups by quartiles of TG, with the lowest quartile (Q1) as the reference group. The primary outcomes were CVD [composite of myocardial infarction (MI) and ischemic stroke] and all-cause mortality. CVD and mortality risks were estimated with Cox regression models.

Results: A total of 43,882 participants were included. Their mean age was 30.6±5.56 years, and 80.2% were males. During a median follow-up of 11.2 years, 298 CVD events and 345 deaths occurred. The incidences of CVD and all-cause mortality were 0.67 and 0.76 per 1,000 person-years, respectively. Compared with individuals in the lowest quartile (Q1), participants in the highest quartile (Q4) showed a 126% higher risk of developing CVD [adjusted hazard ratio (HR) 2.26; 95% confidence interval (CI): 1.56 to 3.29; P=0.001] and a 61% higher risk of all-cause mortality (adjusted HR 1.61; 95% CI: 1.14 to 2.28; P=0.007). In addition, analyses of CVD subtypes showed that adjusted HRs (Q4 vs. Q1) were 3.25 (95% CI: 1.33 to 7.97; P=0.01) for MI, and 1.88 (95% CI: 1.16 to 3.04; P=0.01) for ischemic stroke.

Conclusions: Among Chinese young adults, elevated fasting TG levels were associated with increased CVD and all-cause mortality risks.

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40 岁以下中国成年人的甘油三酯水平与心血管疾病和全因死亡风险：一项前瞻性队列研究。

背景：有关甘油三酯（TG）水平与心血管疾病（CVD）和全因死亡率之间关系的数据主要集中在中老年人群中，有关年轻人的信息非常有限。本研究旨在确定中国年轻成年人中的此类关联：本研究纳入了开滦研究中基线年龄小于 40 岁、未患心血管疾病、癌症和服用降脂药的中国成年人，他们在 2006 年至 2016 年期间入组。所有参与者每两年随访一次，直至 2020 年 12 月。采用酶比色法测量基线空腹总胆固醇。参与者按 TG 四分位数分为四组，以最低四分位数（Q1）为参照组。主要结果是心血管疾病[心肌梗死（MI）和缺血性中风的复合]和全因死亡率。心血管疾病和死亡率风险通过 Cox 回归模型进行估算：结果：共纳入 43 882 名参与者。他们的平均年龄为（30.6±5.56）岁，80.2%为男性。在中位 11.2 年的随访期间，共发生 298 例心血管疾病和 345 例死亡。心血管疾病发病率和全因死亡率分别为每千人年 0.67 例和 0.76 例。与最低四分位数（Q1）的人相比，最高四分位数（Q4）的参与者患心血管疾病的风险高出 126% [调整后危险比 (HR) 2.26；95% 置信区间 (CI)：1.56 至 3.29；P=0.001]，全因死亡风险高出 61%（调整后危险比 1.61；95% 置信区间 (CI)：1.14 至 2.28；P=0.007）。此外，对心血管疾病亚型的分析表明，心肌梗死的调整HR（Q4 vs. Q1）为3.25（95% CI：1.33至7.97；P=0.01），缺血性中风的调整HR为1.88（95% CI：1.16至3.04；P=0.01）：结论：在中国青壮年中，空腹总胆固醇水平升高与心血管疾病和全因死亡风险增加有关。

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来源期刊

Cardiovascular diagnosis and therapy Medicine-Cardiology and Cardiovascular Medicine

CiteScore

4.90

自引率

4.20%

发文量

期刊介绍： The journal ''Cardiovascular Diagnosis and Therapy'' (Print ISSN: 2223-3652; Online ISSN: 2223-3660) accepts basic and clinical science submissions related to Cardiovascular Medicine and Surgery. The mission of the journal is the rapid exchange of scientific information between clinicians and scientists worldwide. To reach this goal, the journal will focus on novel media, using a web-based, digital format in addition to traditional print-version. This includes on-line submission, review, publication, and distribution. The digital format will also allow submission of extensive supporting visual material, both images and video. The website www.thecdt.org will serve as the central hub and also allow posting of comments and on-line discussion. The web-site of the journal will be linked to a number of international web-sites (e.g. www.dxy.cn), which will significantly expand the distribution of its contents.