Hypertriglyceridemic waist: an alternative to the metabolic syndrome? Results of the IMAP Study (multidisciplinary intervention in primary care).
OBJECTIVE
To study the prevalence of hypertriglyceridemic waist (HTGW) in an urban adult Spanish population and its association with type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD).


METHODS
We undertook a cross-sectional analysis in a random sample of 2270 individuals (18-80 years of age). All participants provided a clinical history and underwent a physical examination. Blood and urine analyses were conducted. HTGW was diagnosed using anthropometric criteria for the European population (waist circumference: for men, ≥ 94 cm; for women, ≥ 80 cm) and fasting plasma triglycerides (TGs) ≥ 1.71 mmol l(-1) (≥ 150 mg per 100 ml).


RESULTS
The prevalence of HTGW was 14.5% (men: 18.2%, women: 10.8%) and was significantly greater in men <59 years (P<0.001). HTGW was associated with older individuals, a low educational level and, in men, with a sedentary lifestyle (P<0.001). Subjects with HTGW had higher levels of total cholesterol, low-density lipoprotein-cholesterol (LDL-c) and uric acid, lower levels of high-density lipoprotein-cholesterol, a higher blood pressure, a greater degree of obesity and a higher prevalence of T2DM (20.00 vs 6.4%, P<0.001) (odds ratio (OR) 3.61; 95% confidence interval (95% CI), 2.60-5.01) and CVD (8.5 vs 3.4%, P<0.001) (OR 2.63; 95% CI, 1.66-4.16). The association of HTGW with T2DM and CVD disappeared after adjusting for age. The degree of concordance between HTGW and the metabolic syndrome (MS) was moderate, with both the Adult Treatment Panel III Report (ATP-III) and the International Diabetes Federation criteria (κ=0.51 and κ=0.58, respectively). Subjects with isolated HTGW as compared with those with isolated MS (ATP-III) were younger, had greater levels of total cholesterol, LDL-c and TGs and a lower prevalence of obesity, high blood pressure and dysglycemia.


CONCLUSIONS
HTGW is a phenotype of cardiometabolic risk prevalent in the adult population in our environment. HTGW may be an alternative to MS to detect the population at risk for T2DM and CVD, especially in young individuals who do not fulfill the criteria for MS.
Gomez-Huelgas
R
R
Internal Medicine Department, Carlos Haya Hospital, Malaga, Spain.
Bernal-López
M R
MR
Villalobos
A
A
Mancera-Romero
J
J
Baca-Osorio
A J
AJ
Jansen
S
S
Guijarro
R
R
Salgado
F
F
Tinahones
F J
FJ
Serrano-Ríos
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology*; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology*; D003925:Diabetic Angiopathies / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D015228:Hypertriglyceridemia / Q000097:blood / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000097:blood / Q000453:epidemiology*; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D014280:Triglycerides / Q000097:blood; D014504:Urban Health; D055105:Waist Circumference; D055815:Young Adult
D008076:Cholesterol, HDL; D014280:Triglycerides; D002784:Cholesterol