title: The hypertriglyceridemic-waist phenotype is associated with the Framingham risk score and subclinical atherosclerosis in Canadian Cree.
abstract: OBJECTIVE
  For primary prevention of cardiovascular disease (CVD), Canadian guidelines recommend that asymptomatic Canadians with abdominal obesity undergo Framingham risk score (FRS) assessment, and that in Indigenous Peoples, indicators of metabolic syndrome also be used to identify at-risk individuals. The hypertriglyceridemic-waist phenotype (HTGW) has been proposed to be a surrogate marker of visceral obesity and a simple proxy measure for metabolic syndrome. The primary aim of this study was to evaluate whether the HTGW and the FRS associated with sub-clinical atherosclerosis.
  
  
  RESULTS
  Asymptomatic Cree participants in a cross-sectional study conducted 2005-2009 (n = 446, 18-81 y) were assessed for the HTGW using NCEP-ATP-III gender-specific-cutoffs (waist circumference: for men, ≥102 cm; for women ≥88 cm) and fasting triglycerides ≥1.7 mmol/L. Sub-clinical atherosclerosis was defined by the presence of a high sex-specific common-carotid-intimal-medial-wall-thickness (≥75th percentile). HTGW was present in 26.7% and a 10-y FRS greater than 10% was present in 18.8% of participants. The multivariate adjusted OR (95% CI) for sub-clinical atherosclerosis associated with an FRS greater than 10% was 4.10 (2.20-7.50) while that associated with the HTGW phenotype was 1.74 (95% CI 1.61-1.88) from a model including age, body mass index, alcohol consumption, FRS and the HTGW.
  
  
  CONCLUSIONS
  The HTGW phenotype is prevalent in the Cree. Our findings support further study on the utility of combining the HTGW with the FRS in the prediction of cardiovascular disease outcomes and in health screening and intervention programs among indigenous peoples.
authors.affiliation: Center for Indigenous Peoples' Nutrition and Environment (CINE) & School of Dietetics and Human Nutrition, McGill University, 21,111 Lakeshore, St-Anne-de-Bellevue, Québec, H9X 3V9, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Poirier
authors.affiliation: Center for Indigenous Peoples' Nutrition and Environment (CINE) & School of Dietetics and Human Nutrition, McGill University, 21,111 Lakeshore, St-Anne-de-Bellevue, Québec, H9X 3V9, Canada.
authors.forename: S
authors.initials: S
authors.lastname: Kubow
authors.affiliation: University of Ottawa, 25 Université (Room 140), Ottawa, Ontario, K1N 7K4, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Noël
authors.affiliation: Unité de recherche en santé publique, Université Laval, 2875 Boulevard Laurier, Édifice Delta 2, Bureau 600, Québec, Québec G1V 2M2, Canada.
authors.forename: C
authors.initials: C
authors.lastname: Dupont
authors.affiliation: Division of Epidemiology, Norwegian Institute of Public Health & Department of Global Public Health and Primary Care, University of Bergen, Kalfarveien 31, N-5018 Bergen, Norway. Electronic address: g.egeland@igs.uib.no.
authors.forename: G M
authors.initials: GM
authors.lastname: Egeland
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000097:blood* / Q000150:complications; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D015992:Body Mass Index; D002170:Canada; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015228:Hypertriglyceridemia / Q000097:blood* / Q000150:complications / Q000208:ethnology*; D007198:Indians, North American; D008019:Life Style; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications; D008875:Middle Aged; D015999:Multivariate Analysis; D056128:Obesity, Abdominal / Q000097:blood / Q000150:complications; D010641:Phenotype; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference; D055815:Young Adult
chemical_list: D015415:Biomarkers; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides
keywords: Cree Canadians; Framingham risk score; Hypertriglyceridemic-waist phenotype; Subclinical atherosclerosis