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Triglyceride-based screening tests fail to recognize cardiometabolic disease in African immigrant and
Sophia S K Yu1, Natalie L M Ramsey, Darleen C Castillo
1Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes, Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland 20892-1612, USA.
Insights
Hypertriglyceridemia is an ineffective screening marker for cardiometabolic disease in African and African-American men. Current triglyceride (TG)-based tests miss many individuals, hindering early prevention efforts for this population.
Area of Science:
- Cardiology
- Metabolic Health
- Public Health
Background:
- Cardiometabolic disease prevalence is rising in Africa, necessitating effective screening.
- Triglyceride (TG) levels are commonly used for screening, but their efficacy in African populations is unknown.
- High failure rates of TG-based screening exist in African Americans.
Purpose of the Study:
- To investigate the association between hypertriglyceridemia (TG ≥150 mg/dL) and cardiometabolic disease.
- To assess the utility of TG levels for screening cardiometabolic disease in African and African-American men.
Main Methods:
- Cross-sectional study of 155 healthy self-identified men (80 African immigrants, 75 African Americans).
- Measurements included lipid profiles, oral glucose tolerance tests (OGTT), and insulin sensitivity index (S(I)).
- Cardiometabolic disease defined by subtypes: prediabetes, diabetes, insulin resistance, or metabolic triad.
Main Results:
- Men with cardiometabolic disease had higher TG levels than those without (88±43 vs. 61±26 mg/dL).
- Fewer than 10% of men with cardiometabolic disease, across all subtypes, had TG ≥150 mg/dL.
- Diabetic men identified by OGTT had TG levels ≤100 mg/dL.
Conclusions:
- Hypertriglyceridemia is a poor indicator of cardiometabolic disease in men of African descent.
- TG-based screening tests are inadequate for identifying cardiometabolic disease in African immigrants and African-American men.
- Current screening methods result in missed opportunities for early intervention and prevention.
Background:
The prevalence of cardiometabolic disease in Africa now rivals that of Western nations. Therefore, screening programs that lead to effective prevention of cardiometabolic disease in Africans is imperative. Most screening tests for cardiometabolic disease use triglyceride (TG) levels as a criterion. However, the failure rate of TG-based screening tests in African Americans is high. In Africans, the efficacy of TG-based screening tests is unknown. Our goal was to determine the association between hypertriglyceridemia (TG ≥150 mg/dL) and cardiometabolic disease in African and African-American men.
Research Design And Methods:
This was a cross-sectional study of 155 men (80 African immigrants, 75 African Americans) [age, 35±9 years, mean±standard deviation (SD), body mass index (BMI) 28.5±5.2 kg/m(2)] who self-identified as healthy. Lipid profiles were performed. Glucose tolerance and insulin resistance was determined by oral glucose tolerance tests (OGTT) and the insulin sensitivity index (S(I)), respectively. Cardiometabolic disease was defined by four possible subtypes--prediabetes, diabetes, insulin resistance, or metabolic triad [hyperinsulinemia, hyperapolipoprotein B, small low-density lipoprotein (LDL) particles].
Results:
TG levels were higher in men with cardiometabolic disease than without (88±43 versus 61±26 mg/dL, P<0.01). However, <10% of men with cardiometabolic disease had TG ≥150 mg/dL. Even within each cardiometabolic disease subtype, the prevalence of TG ≥150 mg/dL was <10%. Furthermore, TG levels in the 5% of men identified by OGTT as diabetic were ≤100 mg/dL (mean 71±24, range 45-100 mg/dL).
Conclusions:
Hypertriglyceridemia is a poor marker of cardiometabolic disease in men of African descent. Therefore TG-based screening tests fail to identify both African immigrants and African-American men with cardiometabolic disease. As a consequence, the opportunity for early intervention and prevention is lost.
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