Evaluating CMR

Hypertriglyceridemic waist predicts metabolic abnormalities

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Hypertriglyceridemic waist can also be useful in clinical practice to detect individuals likely to have features of the metabolic syndrome, such as an elevated cholesterol/HDL cholesterol ratio, postprandial hyperlipidemia, hyperinsulinemia, and a dyslipidemic profile typically found in subjects with abdominal obesity. In this regard, Solati et al. (13) reported that 75% of men of the Tehran Lipid and Glucose Study with hypertriglyceridemic waist had four to six risk factors (cholesterol, LDL cholesterol, HDL cholesterol, systolic blood pressure, diastolic blood pressure, and BMI). Other studies have also validated the ability of hypertriglyceridemic waist to identify individuals at high risk of CVD (11, 15, 18-21). Lamonte et al. (11) have published evidence that more than two-thirds of women with elevated waist girth and triglyceride concentrations also had hyperinsulinemia as well as increased apolipoprotein B and LDL cholesterol levels. Furthermore, a clear relationship between hypertriglyceridemic waist and the cholesterol/HDL cholesterol ratio, a well-known strong predictor of CHD (29, 30), has been reported in several study populations (10, 14, 18, 21). The prevalence of subjects with a cholesterol/HDL cholesterol ratio ≥ 6 was almost 50%, whereas it was only 3% among men with both low waist girth and normal triglyceride concentrations (10). Carriers of the hypertriglyceridemic waist phenotype also have deteriorated plasma glucose-insulin homeostasis compared to individuals without this phenotype (10, 11, 18, 20, 21). In addition, a postprandial study revealed that men with hypertriglyceridemic waist had the greatest increase in triglyceride concentrations during the postprandial state compared to control subjects (15). The latter study also indicated that this phenotype was better at identifying a hyperlipidemic state during the postprandial phase than elevated waist circumference or hypertriglyceridemia measured in isolation.

Reference

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10. Lemieux I, Alméras N, Mauriège P, et al. Prevalence of "hypertriglyceridemic waist" in men who participated in the Quebec Health Survey: association with atherogenic and diabetogenic metabolic risk factors. Can J Cardiol 2002; 18: 725-32.

11. LaMonte MJ, Ainsworth BE, DuBose KD, et al. The hypertriglyceridemic waist phenotype among women. Atherosclerosis 2003; 171: 123-30.

13. Solati M, Ghanbarian A, Rahmani M, et al. Cardiovascular risk factors in males with hypertriglycemic waist (Tehran Lipid and Glucose Study). Int J Obes Relat Metab Disord 2004; 28: 706-9.

14. St-Pierre J, Lemieux I, Vohl MC, et al. Contribution of abdominal obesity and hypertriglyceridemia to impaired fasting glucose and coronary artery disease. Am J Cardiol 2002; 90: 15-8.

15. Blackburn P, Lamarche B, Couillard C, et al. Postprandial hyperlipidemia: another correlate of the "hypertriglyceridemic waist" phenotype in men. Atherosclerosis 2003; 171: 327-36.

18. Kahn HS and Valdez R. Metabolic risks identified by the combination of enlarged waist and elevated triacylglycerol concentration. Am J Clin Nutr 2003; 78: 928-34.

19. Bell D, McAuley KA, Mann J, et al. The hypertriglyceridaemic waist in New Zealand Maori. Asia Pac J Clin Nutr 2004; 13: 74-7.

20. Gazi IF, Filippatos TD, Tsimihodimos V, et al. The hypertriglyceridemic waist phenotype is a predictor of elevated levels of small, dense LDL cholesterol. Lipids 2006; 41: 647-54.

21. Hiura Y, Acklin F, Newman J, et al. Hypertriglyceridemic waist as a screening tool for CVD risk in indigenous Australian women. Ethn Dis 2003; 13: 80-4.

29. Kinosian B, Glick H and Garland G. Cholesterol and coronary heart disease: predicting risks by levels and ratios. Ann Intern Med 1994; 121: 641-7.

30. Lemieux I, Lamarche B, Couillard C, et al. Total cholesterol/HDL cholesterol ratio vs LDL cholesterol/HDL cholesterol ratio as indices of ischemic heart disease risk in men. The Quebec Cardiovascular Study. Arch Intern Med 2001; 161: 2685-92.

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