The Association Between Fasting Triglycerides And Carotid Atherosclerosis

BackgroundIn China, the incidence of clinical atherosclerosis increased year by year. The prevention of clinical disease advance to subclinical atherosclerosis diseases, it was an important manifestation of early prevention and treatment of cardiovascular diseases. With prevention advanced, it was became increasingly important of researching and preventing of risk factors of atherosclerosis, and more effective for the prevention of atherosclerosis development. Traditional risk factors only explain7%～16%of the development of carotid atherosclerosis. And blood lipids, blood pressure, glucose and other traditional risk factors had been adjusted, the individual was still faced with a high cardiovascular risk. Many studies suggest triglycerides (TG) may played an important role in the residual risk. However, the association between TG and carotid atherosclerosis was limited and controversial. The studies objectives mostly were older people, or cardiovascular patients, and these studies methods mostly were single factor analysis without adjusted others risk factors. At present lacked our country cohort studies. The studies which researched on the relation of triglycerides and carotid atherosclerosis is more practical in China for preventing atherosclerosis. Because of the characters of atherosclerosis diseases and hyperlipidemia are different in China from the west countries.HypothesisOn the basis of previous prospective studies of large sample on carotid atherosclerosis progression, verify the following hypothesis:the triglyceride may influence on carotid atherosclerosis progression; it improved predictive ability about carotid atherosclerosis on the basis of traditional risk factors.Objectives On the basis of previous prospective studies,(1) To evaluate the association of TG and carotid atherosclerosis by cross-sectional study.(2) To explore the prediction value of TG on progression of carotid atherosclerosis with traditional atherosclerosis risk factors.MethodsThe research population consisted of the elderly population in Beijing. Cohort study was adopted. The baseline population sampling method is cluster sampling on the basis of age (per10-year-old level) and gender stratified random sampling. The baseline survey including CVD risk factors and B-mode ultrasound of carotid artery was performed in2002> and the second follow-up examination was performed in2007. We evaluated1949participants with lipid measurements and B-mode ultrasound of carotid arteries in the two surveys (with mean age as57.9±8.1years and39.2%were men). The baseline TG levels were divided into four groups:group1(<1.13mmol/L), group2(1.13-1.69mmol/L), group3(1.70-2.25mmol/L) and group4(≥2.26mmol/L) newly identified carotid plaque was regarded as the indicators of progression of carotid atherosclerosis. New relationship between fasting TG levels and newly identified carotid plaque was analyzed.ResultsWe evaluated1949participants with mean age as57.9±8.1years, and39.2%were men,60.8%were women.1. The elderly population in Beijing with hypertrilgyceridemia prevalence increased in five years. The hypertrilgyceridemia was21.9%in2002, up to40.7%after5years, and the rate was higher in female than male (43.2%versus36.8%)(P<0.01).2. The prevalence of carotid atherosclerosis in the elderly population in Beijing. The carotid plaque of participants was55.7%, and the rate of newly identified carotid plaque was37.0%, and the rate was higher in male than female (62.4%versus51.3%)(P<0.01). but over65years old, the rate was higher in female than male (76.1%versus73.3%)(P<0.01).3. The cross-sectional study of the association of TG and carotid atherosclerosis:there was not associated TG with identified carotid plaque rate. Compared to newly identified carotid plaque which including different TG level groups, the incidence of newly artery plaque had significantly increased, along with the increase of baseline triglyceride level(30.8%,38.8%,41.9%and44.2%respectively, with χ2=21.22, P<0.01).Compared to individuals (TG<1.13mmol/L), TG seemed a risk factor of plaque progression (P<0.01). After adjusted for age, sex, dyslipidemia and other risk factors, high TG group (TG≥2.26mmol/L) was appeared a significant independent predictor of newly identified carotid plaque (OR=1.37,95%CI:1.00-1.86).When further stratify the traditional atherosclerosis risk factors, we found that high TG group with smoking or hypertension was an independent factor of atherosclerosis progression. The incidence of newly artery plaque was increased161%(P<0.01) and100%(P<0.01) separated.ConclusionsHypertriglyceridemia prevalence of up to40.7%in the elders in Beijing, Hypertriglyceridemia declined with age growth in men, but women’s was increasing.The prevalence of carotid atherosclerosis in the elderly population in Beijing. The carotid plaque of participants was55.7%, and the rate of newly identified carotid plaque was37.0%, and the rate was higher in male than female.The incidence of newly artery plaque had significantly increased, along with the increase of baseline triglyceride level. serum fasting TG>2.26mmol/L was an independent predictors of newly developed carotid plaque.In traditional risk factors of smoking and hypertension, complicated with high level of TG may increased newly carotid plaque risk.In summary, early intervention in the individuals of high TG levels, and comprehensive prevention and treatment of risk factors of atherosclerosis may be an important means of early prevention in atherosclerosis disease.