Relationship between non-fasting triglycerides and cardiovascular disease mortality in a 20-year follow-up study of a Japanese general population: NIPPON DATA90

J Epidemiol. 2021 Jan 16. doi: 10.2188/jea.JE20200399. Online ahead of print.

Abstract

BackgroundNon-fasting triglycerides (TG) are considered a better predictor of cardiovascular disease (CVD) than fasting TG. However, the effect of non-fasting TG on fatal CVD events remains unclear. In the present study, we aimed to explore the relationship between non-fasting TG and CVD mortality in a Japanese general population.MethodsA total of 6,831 participants without a history of CVD, in which those who had a blood sampling over 8 hours or more after a meal were excluded, were followed for 18.0 years. We divided participants into seven groups according to non-fasting TG levels: ≤59 mg/dL, 60-89 mg/dL, 90-119 mg/dL, 120-149 mg/dL, 150-179 mg/dL, 180-209 mg/dL, and ≥210 mg/dL, and estimated the multivariable-adjusted hazard ratios (HRs) of each TG group for CVD mortality after adjusting for potential confounders, including high density lipoprotein cholesterol. Additionally, we performed analysis stratified by age <65 and ≥65 years.ResultsDuring the follow-up period, 433 deaths due to CVD were detected. Compared with a non-fasting TG of 150-179 mg/dL, non-fasting TG ≥210 mg/dL was significantly associated with increased risk for CVD mortality (HR=1.56, 95% CI, 1.01-2.41). Additionally, lower levels of non-fasting TG were also significantly associated with increased risk for fatal CVD. In participants aged ≥65 years, lower levels of non-fasting TG had a stronger impact on increased risk for CVD mortality, while higher levels of non-fasting TG had a stronger impact in those aged <65 years.ConclusionIn a general Japanese population, we observed a U-shaped association between non-fasting TG and fatal CVD events.

Keywords: Japan; cardiovascular disease; general population; mortality; non-fasting triglyceride.