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The association between "hypertriglyceridemic waist" and sub-clinical atherosclerosis in a multiethnic population: a cross-sectional study

Danijela Gasevic1*, Axel C Carlsson23, Iris A Lesser1, GB John Mancini45 and Scott A Lear156

Author Affiliations

1 Department of Biomedical Physiology and Kinesiology, Simon Fraser University, 2600-515 W Hastings Street, Vancouver V6B 5K3, BC, Canada

2 Center for Family and Community Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels allé 12, Huddinge 141 83, Sweden

3 Department of Public Health and Caring Sciences/ Section of Geriatrics Uppsala University, Uppsala, Sweden

4 Department of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada

5 Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada

6 Division of Cardiology, Providence Health Care, Healthy Heart Program, 180 - 1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada

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Lipids in Health and Disease 2014, 13:38  doi:10.1186/1476-511X-13-38

Published: 23 February 2014

Abstract

Background

"Hypertriglyceridemic waist" (HTGW) phenotype, an inexpensive early screening tool for detection of individuals at risk for type 2 diabetes and cardiovascular disease was found to be associated with subclinical atherosclerosis in various patient populations such as those with diabetes mellitus, chronic kidney disease, and those infected with human immunodeficiency virus. However, less is known regarding an association between HTGW and subclinical atherosclerosis in the apparently healthy, multiethnic population. Therefore, the aim of the study was to explore the association between HTGW and sub-clinical atherosclerosis in an apparently healthy, multiethnic population; and to investigate whether the effect of HTGW on sub-clinical atherosclerosis persists over and above the traditional atherosclerosis risk factors.

Methods

We studied 809 individuals of Aboriginal, Chinese, European and South Asian origin who were assessed for indices of sub-clinical atherosclerosis (intima-media thickness (IMT), total area and presence of carotid plaques), socio-demographic and lifestyle characteristics, anthropometrics, lipids, glucose, blood pressure, and family history of cardiovascular disease.

Results

We found that, compared to individuals without HTGW and after adjusting for age, ethnicity, smoking, and physical activity; men and women with HTGW had a significantly higher: IMT (men: B (95%CI = 0.084 (0.037, 1.133), p < 0.001; women: B (95%CI) = 0.041 (0.006, 0.077), p = 0.020); and total area (men: B (95%CI = 0.202 (0.058, 0.366), p = 0.005; women: B (95%CI) = 0.115 (0.006, 0.235), p = 0.037). The association between HTGW waist and presence of plaques was significant for men (OR (95%CI) = 1.904 (1.040, 3.486), p = 0.037 vs. men without HTGW), but not for women (p = 0.284). Once analyses were adjusted for additional, traditional risk factors for atherosclerosis, the effect of HTGW on sub-clinical atherosclerosis was no longer significant.

Conclusions

In conclusion, HTGW may serve as an early marker of subclinical atherosclerosis in men and women, irrespective of ethnicity. However, once individuals are assessed for all traditional risk factors for atherosclerosis, the additional assessment for HTGW is not warranted.

Keywords:
Hypertriglyceridemic waist; Sub-clinical atherosclerosis; Intima-media thickness; Atherosclerotic plaque; Ethnicity