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American Journal of Epidemiology Vol. 153, No. 5 : 490-499
Copyright © 2001 by The Johns Hopkins University School of Hygiene and Public Health


ORIGINAL CONTRIBUTIONS

Serum Triglycerides and Risk of Coronary Heart Disease among Japanese Men and Women

Hiroyasu Iso1, Yoshihiko Naito2, Shinichi Sato2, Akihiko Kitamura2, Tomonori Okamura2, Tomoko Sankai1, Takashi Shimamoto1, Minoru Iida2 and Yoshio Komachi3

1 Institute of Community Medicine, University of Tsukuba, Tsukuba-shi, Ibaraki-ken, Japan.
2 Department of Epidemiology and Mass Examination for Cardiovascular Diseases, Osaka Medical Center for Cancer and Cardiovascular Diseases, Nakamichi, Higashinari-ku, Osaka, Japan.
3 Osaka Prefectural Institute of Public Health, 1-3-69 Nakamichi, Higashinari-ku, Osaka, Japan.

To examine the relation of triglycerides with coronary heart disease among populations with low mean total cholesterol, the authors conducted a 15.5-year prospective study ending in 1997 of 11,068 Japanese aged 40–69 years (4,452 men and 6,616 women with mean total cholesterol = 4.73 mmol/liter and 5.03 mmol/liter, respectively), initially free of coronary heart disease or stroke. There were 236 coronary heart disease events comprising 133 myocardial infarctions, 68 angina pectoris events, and 44 sudden cardiac deaths. The coronary heart disease incidence was greater in a dose-response manner across increasing quartiles of nonfasting triglycerides for both sexes. The multivariate relative risk of coronary heart disease adjusting for coronary risk factors and time since last meal associated with a 1-mmol/liter increase in triglycerides was 1.29 (95% confidence interval (CI): 1.09, 1.53; p = 0.004) for men and 1.42 (95% CI: 1.15, 1.75; p = 0.001) for women. The trend was similar for myocardial infarction, angina pectoris, and sudden cardiac death. The relation of triglycerides with coronary heart disease was not influenced materially by total cholesterol levels or, in a subsample analysis (51% of total sample), by high density lipoprotein cholesterol levels. Nonfasting serum triglycerides predict the incidence of coronary heart disease among Japanese men and women who possess low mean values of total cholesterol. Further adjustment for high density lipoprotein cholesterol suggests an independent role of triglycerides on the coronary heart disease risk.

cholesterol; coronary disease; incidence; triglycerides

Abbreviations: CI, confidence interval; HDL, high density lipoprotein; LDL, low density lipoprotein; SD, standard deviation.


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