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Triglyceride expression
S Krishnaswami1, G Joseph, S T Chandy
1Department of Cardiology, Christian Medical College Hospital, Vellore, Tamilnadu, India.
Insights
Triglycerides play a significant role in coronary artery disease (CAD) development, especially in older adults. This study found triglycerides were more strongly associated with CAD in patients over 51, unlike cholesterol, which was more linked in younger individuals.
Area of Science:
- Cardiology
- Epidemiology
- Lipid Metabolism
Background:
- Epidemiologic reports highlight the role of triglycerides in coronary artery disease (CAD).
- Understanding lipid profiles' association with CAD across different age groups is crucial for risk stratification.
Purpose of the Study:
- To assess the role of triglycerides in coronary artery disease (CAD) across various age groups.
- To compare the association of different lipid fractions (cholesterol, triglycerides, HDL, LDL) with CAD in younger versus older patients.
Main Methods:
- Cross-sectional data analysis of 1726 patients (1119 with CAD, 607 normal coronaries) presenting with chest pain.
- Logistic regression analysis using mean values of lipid profiles and BMI from normal subjects as demarcation lines.
- Stratification of male patients into age groups: <40, 41-50, 51-60, >61 years; females: <50, >51 years.
Main Results:
- Total cholesterol showed higher odds ratios for CAD in younger age groups.
- Triglycerides demonstrated consistently higher odds ratios for CAD in both males and females over 51 years.
- Age appears to modify the relative importance of lipid fractions in the development of atherosclerotic plaque.
Conclusions:
- Triglycerides may be equally or more important than cholesterol in the development of CAD in older individuals (>51 years).
- Cholesterol may play a more significant role in CAD development among younger populations.
- Metabolic handling of lipid fractions might differ with age, influencing their impact on atherosclerosis.
Abstract:
Current epidemiologic reports claim an important role for triglycerides in coronary artery disease (CAD). By cross-sectional data analysis, the role of triglycerides was assessed in 1726 consecutive patients investigated for chest pain, 1119 with CAD and 607 with normal coronaries. Besides study of male and female patients as separate groups, the males were divided into age groups of below 40 years, 41 to 50 years, 51 to 60 years and over 61 years. The female patients were divided into those below 50 years and over 51 years because of smaller numbers. Using the mean value for cholesterol, triglyceride, HDL cholesterol, LDL cholesterol and body mass index for normals as the demarcation line, logistic regression analysis was carried out to study their association in the patients with CAD and normals. Results showed that while the odds ratio for total cholesterol were higher for the younger age groups, the odds ratio for triglycerides were consistently higher for the groups over 51 years both male and female. It is speculated that there may be a difference in the relative importance of lipid fractions with reference to age in the development of atherosclerotic plaque with cholesterol playing a more important role in younger people and triglycerides being equally or more important in older people, on the basis of metabolic handling of lipid fractions.