Elsevier

Metabolism

Volume 58, Issue 5, May 2009, Pages 661-667
Metabolism

Low-grade inflammation in individuals with the hypertriglyceridemic waist phenotype: Another feature of the atherogenic dysmetabolism

https://doi.org/10.1016/j.metabol.2009.01.005Get rights and content

Abstract

The purpose of this study was to explore the possibility that the recently described “hypertriglyceridemic waist” (HTGW) phenotype, a risk for future coronary artery disease, is associated with the presence of low-grade inflammation. This is a cross-sectional study in a cohort of apparently healthy nondiabetic employed individuals in whom the presence of low-grade inflammation was determined by using the Dade Behring high-sensitivity C-reactive protein (hs-CRP) assay. We have presently analyzed the results obtained in 9842 apparently healthy individuals, at a mean (SD) age of 44 (11) years. We identified 1249 individuals (70.0% men) with HTGW phenotype according to the cutoff points of waist girth of at least 90 cm for men and at least 85 cm for women and triglycerides levels of at least 177 mg/dL for men and at least 133 mg/dL for women. In addition, we identified 1164 individuals (69.3% men) with the metabolic syndrome (MetS) according to the updated Adult Treatment Panel III criteria. The mean (SD) of hs-CRP was 1.3 (2.9) mg/L for the 8055 individuals who had neither the HTGW phenotype nor the MetS, 2.1 (2.7) mg/L for those who had the HTGW phenotype and no MetS, and 2.5 (2.7) for 538 individuals with the MetS and no HTGW phenotype, whereas those who had both atherogenic disorders presented an hs-CRP concentration of 2.9 (2.3) mg/L. In this cohort of apparently healthy nondiabetic employed individuals, the HTGW phenotype had a similar prevalence as the MetS and was associated with the presence of low-grade inflammation. This inflammation could be a pathophysiologic link between this dysmetabolism and atherothrombosis. In addition, the HTGW phenotype is relatively prevalent and could be a simple and inexpensive way to single out individuals at risk for future coronary artery disease.

Introduction

The hypertriglyceridemic waist (HTGW) phenotype might be an inexpensive clinical method of identifying elevated coronary artery disease (CAD) risk among asymptomatic individuals as well as patients with glucose intolerance and type 2 diabetes mellitus [1], [2], [3]. The HTGW phenotype is characterized by the presence of an atherogenic metabolic triad of hyperinsulinemia; elevated apolipoprotein B; and small, dense low-density lipoprotein (LDL) [1], [4]. We have presently explored the possibility that the HTGW phenotype is also associated with the presence of low-grade inflammation. The presence of an acute phase response could explain, at least in part, the association between this dysmetabolic and atherogenic metabolism and the risk of developing CAD.

Section snippets

Study population

In the present study, we analyzed the data collected during the last 5 years in the Tel Aviv Medical Center Inflammation Survey, a registered data bank of the Israeli Ministry of Justice [5], [6], [7], [8], [9], [10], [11]. This is a relatively large survey composed of apparently healthy individuals attending a center for periodic health examinations.

Protocol

In the present study, patients attending the Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, for a routine health examination between

Results

We have presently analyzed the results obtained in 9842 individuals at a mean (SD) age of 44 (11) years. One thousand two hundred forty-nine (12.7%) had the HTGW phenotype, 1164 (11.8%) had the MetS, whereas 8055 (81.8%) individuals had neither the HTGW nor the MetS. We identified 623 individuals with HTGW and no MetS, 538 with the MetS and no HTGW, and 626 with both the MetS and the HTGW phenotype.

In Table 1, we report the different clinical variables of the different groups, whereas the

Discussion

Although previously reported in a relatively small (n = 137) group of women [2], the present study is the first to analyze the presence of low-grade inflammation in both sexes and in a relatively large number of individuals with the HTGW phenotype. Because both low-grade inflammation [18], [19], [20], [21] and the HTGW phenotype [1], [3] predict future cardiovascular events, the presence of the acute phase might be one of the mechanisms that associate the HTGW phenotype with these vascular

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    Ori Rogowski and Itzhak Shapira should both be considered first authors.

    Competitive interests: None. Ethical approval: Ethical approval was granted to this study. Contribution: All authors contributed to the planning and analysis of the study, the interpretation of the results, as well as the writing of the paper. All the authors have approved the final manuscript.

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