Impact of lowering triglycerides on raising HDL-C in hypertriglyceridemic and non-hypertriglyceridemic subjects.
Although an inverse association between triglyceride (TG) and (HDL-C) is well documented, the impact of lowering TG on HDL-C levels has not been well established. Therefore, data were analyzed in 151 consecutive dyslipidemic patients who made multiple visits (n=1830) to the University of Maryland Preventive Cardiology Center between 1991 and 2005. At baseline, fasting TG levels at or above the median (178 mg/dL) were associated with significantly lower HDL-C than TG levels below the median (32.6+/-11.1 mg/dL versus 45.1+/-14.2 mg/dL; P<0.0001). Following baseline evaluation, various therapies were employed (i.e., dietary, exercise, medication) to reduce mean LDL (147.3+/-53.4 mg/dL) and TG (306.1+/-414.9 mg/dL). Using a fully adjusted mixed regression model, each 50 mg/dL reduction in TG was independently associated with a 0.5 mg/dL increase in HDL-C in hypertriglyceridemic subjects (e.g., TG> or =200 mg/dL) and a 1.7 mg/dL increase in HDL-C in the absence of elevated TG (P<0.0001). The use of niacin (P<0.0001), statins (P=0.0003) and fibrates (P=0.03) were also associated with significant increases in HDL-C beyond that anticipated with TG reduction. These data indicate that lowering TG is independently and inversely correlated with HDL-C, effects that are most pronounced in the absence of hypertriglyceridemia.
Miller
Michael
M
Department of Medicine, University of Maryland Medical Center and Veterans Affairs Medical Center, Baltimore, MD, United States. mmiller@medicine.umaryland.edu
Langenberg
Patricia
P
Havas
Stephen
S
D000428:Alcohol Drinking; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood*; D004032:Diet; D015444:Exercise; D005260:Female; D006801:Humans; D015228:Hypertriglyceridemia / Q000097:blood* / Q000517:prevention & control*; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009525:Niacin / Q000627:therapeutic use; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D014280:Triglycerides / Q000097:blood*
D008076:Cholesterol, HDL; D000960:Hypolipidemic Agents; D014280:Triglycerides; D009525:Niacin