High prevalence of C-reactive protein elevation with normal triglycerides (100-149 mg/dL): are triglyceride levels below 100 mg/dL more optimal in coronary heart disease risk assessment?
BACKGROUND
The National Cholesterol Education Program defines a fasting triglyceride level below 150 mg/dL as normal. However, observational data suggest that triglyceride levels above 100 mg/dL may predict coronary heart disease (CHD) events.


METHODS
To determine the prevalence of systemic inflammation with a normal triglyceride level (100-149 mg/dL), data obtained from the population-based cross-sectional study of 4412 men and women in the third National Health and Nutrition Examination Survey were reviewed. Measurements included fasting lipids and lipoproteins and serum C-reactive protein (CRP) level measured using a Behring Nephelometer Analyzer System.


RESULTS
High CRP level was equally prevalent whether the designated triglyceride cutpoint was greater than or equal to 100 (unadjusted OR, 2.0; 95% CI, 1.7-2.3) or greater than or equal to 150 (unadjusted OR, 1.9; 95% CI, 1.6-2.2). After adjustment for other covariates, the triglyceride range of 100 to 149 mg/dL remained independently associated with elevated CRP level (OR, 1.3; 95% CI, 1.02-1.67). In addition, an approximately fivefold higher likelihood of elevated CRP level was observed with triglyceride levels between 100 and 149 mg/dL and normal body mass index (BMI; 24-24.9) compared with lower triglyceride level (<65 mg/dL) and BMI (<22) (P < 0.0001).


CONCLUSIONS
These data indicate that "normal" triglyceride levels (100-150 mg/dL) are associated with systemic inflammation and that lower fasting triglyceride levels (eg, <100 rather than <150 mg/dL) may be a more optimal cutpoint in CHD risk assessment.
Ahmad
Irfan
I
School of Public Health, Yale University, New Haven, Connecticut, USA.
Zhan
Min
M
Miller
Michael
M
D000328:Adult; D002097:C-Reactive Protein / Q000032:analysis*; D003327:Coronary Disease / Q000097:blood* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D018570:Risk Assessment; D014280:Triglycerides / Q000097:blood*
D014280:Triglycerides; D002097:C-Reactive Protein