Introduction: The independent effect of serum triglyceride (TG) level on the development of cardiovascular disease (CVD) has been inconclusive, which might be due to heterogeneity of study populations. We aimed to evaluate the effect of TG level on CVD and mortality in Korean women with stratification according to the menopausal status, diabetes mellitus (DM) or LDL cholesterol level (LDL-C).
Method: We investigated Korean women aged 40-69 years who underwent health examination in 2009 and were followed up until 2018 using nationwide claim data covering 97.0% of the Korean population. The subjects were divided into four groups according to TG quartiles (Q): Q1 <70 mg/dL, Q2 71-99 mg/dL, Q3 100-142 mg/dL, Q4 ≥143 mg/dL. The primary outcome was the incidence of CVD defined as composite of myocardial infarction and ischemic stroke.
Results: Among 2,208,347 women, primary outcome occurred in 62,255 (2.8%) subjects. As TG levels increased, the event rate of primary outcome increased in both premenopausal and postmenopausal women in the fully adjusted model (hazard ration [HR] per 1 Q, 1.10 [95% confidence interval (CI), 1.08-1.12] and 1.08 [95% CI, 1.07-1.09], respectively), which was maintained on further stratification according to DM or LDL-C (p<0.05 in all). In premenopausal women without diabetes and LDL-C of less than 130 mg/dL, even those in Q2 had a significantly higher CVD risk compared to subjects in Q1 (p<0.05), which was not found in the in subjects with diabetes or in the higher range of LDL-C.
Conclusion: TG is an independent prognosticator in the development of CVD in the Korean women aged 40-69 years. The dose-response relationship is more significant in patients without diabetes when LDL-C<130mg/dL. These results imply that more emphasis should be set on TG when assessing women with elevated TG levels with otherwise few established risk factors.
H. Choe: None. M. Moon: None. B. Koo: None.