Changes in triglyceride levels and risk for coronary heart disease in young men.
BACKGROUND
Current triglyceride levels might be only a weak predictor of risk for coronary heart disease (CHD).


OBJECTIVE
To assess the association between changes over time in fasting triglyceride levels and CHD risk in young adults.


METHODS
Follow-up study over 5.5 years after 2 measurements of fasting triglycerides 5 years apart.


METHODS
The Staff Periodic Examination Center of the Israel Defense Forces, Zrifin, Israel.


METHODS
13,953 apparently healthy, untreated, young men (age 26 to 45 years) with triglyceride levels less than 3.39 mmol/L (<300 mg/dL).


METHODS
Two triglyceride measurements (at enrollment [time 1] and 5 years later [time 2]), lifestyle variables, and incident cases of angiography-proven CHD.


RESULTS
Within 5.5 years, 158 new cases of CHD were identified. The multivariate model was adjusted for age; family history; fasting glucose; high-density lipoprotein cholesterol; blood pressure; body mass index; and changes between time 1 and time 2 in body mass index, physical activity, smoking status, and habit of eating breakfast. Investigators categorized triglyceride levels according to low, intermediate, and high tertiles (as measured at time 1 and time 2 [expressed as tertile at time 1/tertile at time 2]). The risk for CHD in men with high-tertile triglyceride levels at time 1 changed depending on the tertile at time 2 (hazard ratios, 8.23 [95% CI, 2.50 to 27.13] for high/high, 6.84 [CI, 1.95 to 23.98] for high/intermediate, and 4.90 [CI, 1.01 to 24.55] for high/low, compared with the stable low/low group). The risk for CHD in men with low-tertile levels at time 1 also changed depending on the tertile at time 2 (hazard ratios, 3.81 [CI, 0.96 to 15.31] for low/intermediate and 6.76 [CI, 1.34 to 33.92] for low/high, compared with the stable low/low group).


CONCLUSIONS
Participants were healthy and had a low incidence rate of CHD. The study was observational.


CONCLUSIONS
Two triglyceride measurements obtained 5 years apart may assist in assessing CHD risk in young men. A decrease in initially elevated triglyceride levels is associated with a decrease in CHD risk compared with stable high triglyceride levels. However, this risk remains higher than in those with persistently low triglyceride levels.
Tirosh
Amir
A
Sheba Medical Center, Tel-Hashomer, Israel.
Rudich
Assaf
A
Shochat
Tzippora
T
Tekes-Manova
Dorit
D
Israeli
Eran
E
Henkin
Yaakov
Y
Kochba
Ilan
I
Shai
Iris
I
D000328:Adult; D003327:Coronary Disease / Q000097:blood* / Q000453:epidemiology; D004562:Electrocardiography / Q000379:methods; D005080:Exercise Test; D005215:Fasting; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D008019:Life Style; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood*
D014280:Triglycerides