Features of the metabolic syndrome of "hypertriglyceridemic waist" and transplant coronary artery disease.
BACKGROUND
This study evaluated the prevalence of the atherogenic metabolic triad and the hypothesis that waist circumference and fasting triglyceride concentrations could be used as screening tools for identification of the atherogenic metabolic triad in a population of heart transplant men. It also evaluated the relationship between the atherogenic metabolic triad and coronary artery disease (CAD).


METHODS
In the study group of 83 consecutive male heart transplant patients having their routine annual coronarography, 23 patients (28%) were characterized by the atherogenic metabolic triad defined by the presence of elevated fasting insulin and apolipoprotein B concentrations and by small low-density lipoprotein (LDL) particles.


RESULTS
Seventy-seven per cent of patients with waist circumference values >/= 90 cm and with elevated triglyceride levels (>/=2.0 mmol/liter) were characterized by this atherogenic metabolic triad. Patients with the atherogenic metabolic triad were at markedly increased risk of CAD (odds ratio of 25.3, 95% CI: 1.11-577.3, p < 0.04) compared to heart transplant patients without the atherogenic metabolic triad.


CONCLUSIONS
About 30% of heart transplant patients showed the features of the atherogenic metabolic triad. Measurement and interpretation of waist circumference and fasting triglycerides could be used among heart transplant patients to early identify men characterized by the presence of elevated fasting insulin and apolipoprotein B concentrations and small LDL particles. The presence of the atherogenic metabolic triad identified patients at high risk of CAD even in the heart transplant population.
Québec Heart Institute, Laval Hospital Research Center, Ste-Foy, Québec, Canada.
Mario
M
Sénéchal
Isabelle
I
Lemieux
Isabel
I
Beucler
Gerard
G
Drobinski
Sylvie
S
Cormont
Michelle
M
Dubois
Iradj
I
Gandjbakhch
Jean-Pierre
JP
Després
Richard
R
Dorent
D050153:Abdominal Fat; D000293:Adolescent; D000328:Adult; D000368:Aged; D001055:Apolipoproteins B / Q000097:blood; D050197:Atherosclerosis / Q000175:diagnosis; D001837:Body Weights and Measures; D003327:Coronary Disease / Q000209:etiology; D016027:Heart Transplantation; D006801:Humans; D007328:Insulin / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis*; D008875:Middle Aged; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
D001055:Apolipoproteins B; D007328:Insulin; D014280:Triglycerides