Fasting compared with nonfasting triglycerides and risk of cardiovascular events in women.

摘要: ContextThe association of triglycerides with incident cardiovascular disease remains controversial. Although triglyceride levels are typically obtained in the fasting state, postprandial hypertriglyceridemia may play an important role atherosclerosis.ObjectiveTo determine (fasting vs nonfasting) and risk future events.Design, Setting, ParticipantsProspective study 26 509 initially healthy US women (20 118 6391 participating Women's Health Study, enrolled between November 1992 July 1995 undergoing follow-up for a median 11.4 years. Triglyceride were measured blood samples at time enrollment.Main Outcome MeasureHazard ratios events (nonfatal myocardial infarction, nonfatal ischemic stroke, coronary revascularization, or death).ResultsAt baseline, as well nonfasting correlated traditional cardiac factors markers insulin resistance. During years, 1001 participants experienced event (including 276 infarctions, 265 strokes, 628 revascularizations, 163 deaths), overall rate 3.46 per 1000 person-years follow-up. After adjusting age, pressure, smoking, use hormone therapy, both predicted events. Among participants, further adjustment total high-density lipoprotein cholesterol measures resistance weakened this (fully adjusted hazard ratio [95% confidence interval] increasing tertiles levels: 1 [reference], 1.21 [0.96-1.52], 1.09 [0.85-1.41] [P = .90 trend]). In contrast, maintained strong independent relationship fully models (hazard 1.44 [0.90-2.29], 1.98 [1.21-3.25] [P = .006 secondary analyses stratified by since participants' last meal, 2 to 4 hours postprandially had strongest highest lowest levels, 4.48 [1.98-10.15] [P<.001 trend]), progressively decreased longer periods fasting.ConclusionsIn cohort women, associated events, factors, other lipids, resistance; showed little relationship.