This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (163)  • Contact me when this article is cited  Related Content  • Related letters  • Related articles  • Similar articles in JAMA  Topic Collections  • Cardiovascular System  • Cardiovascular Disease/ Myocardial Infarction  • Alert me on articles by topic  Social Bookmarking   What's this?

Børge G. Nordestgaard, MD, DMSc; Marianne Benn, MD, PhD; Peter Schnohr, MD; Anne Tybjærg-Hansen, MD, DMSc

JAMA. 2007;298:299-308.

Context  Elevated nonfasting triglycerides indicate the presence of remnant lipoproteins, which may promote atherosclerosis.

Objective  To test the hypothesis that very high levels of nonfasting triglycerides predict myocardial infarction (MI), ischemic heart disease (IHD), and death.

Design, Setting, and Participants  A prospective cohort study of 7587 women and 6394 men from the general population of Copenhagen, Denmark, aged 20 to 93 years, followed up from baseline (1976-1978) until 2004.

Main Outcome Measures  Hazard ratios (HRs) for incident MI, IHD, and total death according to baseline nonfasting triglyceride level categories of 1 to 1.99 mmol/L (88.5-176.1 mg/dL), 2 to 2.99 mmol/L (177.0-264.6 mg/dL), 3 to 3.99 mmol/L (265.5-353.0 mg/dL), 4 to 4.99 mmol/L (354.0-441.6 mg/dL), and 5 mmol/L or more (442.5 mg/dL) vs triglyceride levels of less than 1 mmol/L (<88.5 mg/dL).

Results  With increasing levels of nonfasting triglycerides, levels of remnant lipoprotein cholesterol increased. During a mean follow-up of 26 years, 1793 participants (691 women and 1102 men) developed MI, 3479 (1567 women and 1912 men) developed IHD, and 7818 (3731 women and 4087 men) died. For MI, among women, the age-adjusted HRs and multifactorially adjusted HRs (aHRs) for each respective category per 1-mmol/L increase in nonfasting triglyceride levels were 2.2 (aHR, 1.7), 4.4 (aHR, 2.5), 3.9 (aHR, 2.1), 5.1 (aHR, 2.4), and 16.8 (aHR, 5.4); for both, P for trend < .001. For MI, among men, the values were 1.6 (aHR, 1.4), 2.3 (aHR, 1.6), 3.6 (aHR, 2.3), 3.3 (aHR, 1.9), and 4.6 (aHR, 2.4); for both, P for trend < .001. For IHD, among women, the values were 1.7 (aHR, 1.4), 2.8 (aHR, 1.8), 3.0 (aHR, 1.8), 2.1 (aHR, 1.2), and 5.9 (aHR, 2.6); for both, P for trend < .001. For IHD, among men, the values were 1.3 (aHR, 1.1), 1.7 (aHR, 1.3), 2.1 (aHR, 1.3), 2.0 (aHR, 1.2), and 2.9 (aHR, 1.5); P for trend < .001 for age-adjusted and P for trend = .03 for multifactorially adjusted. For total death, among women, the values were 1.3 (aHR, 1.3), 1.7 (aHR, 1.6), 2.2 (aHR, 2.2), 2.2 (aHR, 1.9), and 4.3 (aHR, 3.3); for both, P for trend < .001. For total death, among men, the values were 1.3 (aHR, 1.2), 1.4 (aHR, 1.4), 1.7 (aHR, 1.5), 1.8 (aHR, 1.6), and 2.0 (aHR, 1.8); for both, P for trend < .001.

Conclusion  In this general population cohort, elevated nonfasting triglyceride levels were associated with increased risk of MI, IHD, and death in men and women.

Author Affiliations: Department of Clinical Biochemistry, Herlev University Hospital, Herlev (Drs Nordestgaard and Benn), The Copenhagen City Heart Study, Bispebjerg University Hospital, Copenhagen (Drs Nordestgaard, Schnohr, and Tybjærg-Hansen), and Department of Clinical Biochemistry, Rigshospitalet, Copenhagen University Hospital (Dr Tybjærg-Hansen), University of Copenhagen, Copenhagen, Denmark.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED LETTERS

Nonfasting Triglycerides and Cardiovascular Risk
William S. Yancy, Jr, Jeff S. Volek, and Eric C. Westman
JAMA. 2007;298(17):2004.
EXTRACT | FULL TEXT  

Nonfasting Triglycerides and Cardiovascular Risk
Konstantinos Tsarpalis
JAMA. 2007;298(17):2004-2005.
EXTRACT | FULL TEXT  

Nonfasting Triglycerides and Cardiovascular Risk—Reply
Børge G. Nordestgaard, Marianne Benn, and Anne Tybjærg-Hansen
JAMA. 2007;298(17):2005.
EXTRACT | FULL TEXT  

Nonfasting Triglycerides and Cardiovascular Risk—Reply
Paul M Ridker
JAMA. 2007;298(17):2005-2006.
EXTRACT | FULL TEXT  

RELATED ARTICLES

Fasting Compared With Nonfasting Triglycerides and Risk of Cardiovascular Events in Women
Sandeep Bansal, Julie E. Buring, Nader Rifai, Samia Mora, Frank M. Sacks, and Paul M Ridker
JAMA. 2007;298(3):309-316.
ABSTRACT | FULL TEXT  

Triglycerides and Risk for Coronary Heart Disease
Patrick E. McBride
JAMA. 2007;298(3):336-338.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Effects of a Plant-Based High-Carbohydrate/High-Fiber Diet Versus High-Monounsaturated Fat/Low-Carbohydrate Diet on Postprandial Lipids in Type 2 Diabetic Patients
De Natale et al.
Diabetes Care 2009;32:2168-2173.
ABSTRACT | FULL TEXT  

Major Lipids, Apolipoproteins, and Risk of Vascular Disease
The Emerging Risk Factors Collaboration
JAMA 2009;302:1993-2000.
ABSTRACT | FULL TEXT  

Lipid Profile Components and Risk of Ischemic Stroke: The Northern Manhattan Study (NOMAS)
Willey et al.
Arch Neurol 2009;66:1400-1406.
ABSTRACT | FULL TEXT  

Limitations of Automated Remnant Lipoprotein Cholesterol Assay for Diagnostic Use
Schaefer
Clin. Chem. 2009;55:2061-2062.
FULL TEXT  

Cholesteryl ester transfer protein: at the heart of the action of lipid-modulating therapy with statins, fibrates, niacin, and cholesteryl ester transfer protein inhibitors
Chapman et al.
Eur Heart J 2009;0:ehp399v1-ehp399.
ABSTRACT | FULL TEXT  

Alcohol Intake, Myocardial Infarction, Biochemical Risk Factors, and Alcohol Dehydrogenase Genotypes
Tolstrup et al.
Circ Cardiovasc Genet 2009;2:507-514.
ABSTRACT | FULL TEXT  

Measures of postprandial lipoproteins are not associated with coronary artery disease in patients with type 2 diabetes mellitus
Reyes-Soffer et al.
J. Lipid Res. 2009;50:1901-1909.
ABSTRACT | FULL TEXT  

Postprandial Glucose Improves the Risk Prediction of Cardiovascular Death Beyond the Metabolic Syndrome in the Nondiabetic Population
Lin et al.
Diabetes Care 2009;32:1721-1726.
ABSTRACT | FULL TEXT  

Antenatal Micronutrient Supplementation Reduces Metabolic Syndrome in 6- to 8-Year-Old Children in Rural Nepal
Stewart et al.
J. Nutr. 2009;139:1575-1581.
ABSTRACT | FULL TEXT  

Common lipid-altering gene variants are associated with therapeutic intervention thresholds of lipid levels in older people
Murray et al.
Eur Heart J 2009;30:1711-1719.
ABSTRACT | FULL TEXT  

Differential effects of protein quality on postprandial lipemia in response to a fat-rich meal in type 2 diabetes: comparison of whey, casein, gluten, and cod protein
Mortensen et al.
Am. J. Clin. Nutr. 2009;90:41-48.
ABSTRACT | FULL TEXT  

Physical Activity, Blood Lipids, and Lipoproteins
Mestek
AMERICAN JOURNAL OF LIFESTYLE MEDICINE 2009;3:279-283.
ABSTRACT  

Genetically Elevated Lipoprotein(a) and Increased Risk of Myocardial Infarction
Kamstrup et al.
JAMA 2009;301:2331-2339.
ABSTRACT | FULL TEXT  

Activation of farnesoid X receptor prevents atherosclerotic lesion formation in LDLR-/- and apoE-/- mice
Hartman et al.
J. Lipid Res. 2009;50:1090-1100.
ABSTRACT | FULL TEXT  

Large scale replication analysis of loci associated with lipid concentrations in a Japanese population
Nakayama et al.
J. Med. Genet. 2009;46:370-374.
ABSTRACT | FULL TEXT  

Fructose Consumption: Considerations for Future Research on Its Effects on Adipose Distribution, Lipid Metabolism, and Insulin Sensitivity in Humans
Stanhope and Havel
J. Nutr. 2009;139:1236S-1241S.
ABSTRACT | FULL TEXT  

Identification of a New Functional Domain in Angiopoietin-like 3 (ANGPTL3) and Angiopoietin-like 4 (ANGPTL4) Involved in Binding and Inhibition of Lipoprotein Lipase (LPL)
Lee et al.
J. Biol. Chem. 2009;284:13735-13745.
ABSTRACT | FULL TEXT  

Endocrine and Metabolic Effects of Consuming Fructose- and Glucose-Sweetened Beverages with Meals in Obese Men and Women: Influence of Insulin Resistance on Plasma Triglyceride Responses
Teff et al.
J. Clin. Endocrinol. Metab. 2009;94:1562-1569.
ABSTRACT | FULL TEXT  

Baseline C-Reactive Protein Is Associated With Incident Cancer and Survival in Patients With Cancer
Allin et al.
JCO 2009;27:2217-2224.
ABSTRACT | FULL TEXT  

Proprotein Convertase Subtilisin Kexin Type 9 Null Mice Are Protected From Postprandial Triglyceridemia
Le May et al.
Arterioscler. Thromb. Vasc. Bio. 2009;29:684-690.
ABSTRACT | FULL TEXT  

Fasting and Nonfasting LDL Cholesterol: To Measure or Calculate?
Nordestgaard and Benn
Clin. Chem. 2009;55:845-847.
FULL TEXT  

Triglycerides, Depression, and Risk of Ischemic Stroke--Reply
Freiberg et al.
JAMA 2009;301:1339-1339.
FULL TEXT  

Hepatic Lipase, Genetically Elevated High-Density Lipoprotein, and Risk of Ischemic Cardiovascular Disease
Johannsen et al.
J. Clin. Endocrinol. Metab. 2009;94:1264-1273.
ABSTRACT | FULL TEXT  

Hypertriglyceridemia and Its Pharmacologic Treatment Among US Adults
Ford et al.
Arch Intern Med 2009;169:572-578.
ABSTRACT | FULL TEXT  

Effects of Fenofibrate Treatment on Cardiovascular Disease Risk in 9,795 Individuals With Type 2 Diabetes and Various Components of the Metabolic Syndrome: The Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study
Scott et al.
Diabetes Care 2009;32:493-498.
ABSTRACT | FULL TEXT  

Polyunsaturated Fatty Acids Modulate the Effect of TCF7L2 Gene Variants on Postprandial Lipemia
Warodomwichit et al.
J. Nutr. 2009;139:439-446.
ABSTRACT | FULL TEXT  

Age at birth of first child and coronary heart disease risk factors at age 53 years in men and women: British birth cohort study
Hardy et al.
J. Epidemiol. Community Health 2009;63:99-105.
ABSTRACT | FULL TEXT  

Elevated Plasma YKL-40 Predicts Increased Risk of Gastrointestinal Cancer and Decreased Survival After Any Cancer Diagnosis in the General Population
Johansen et al.
JCO 2009;27:572-578.
ABSTRACT | FULL TEXT  

Brief oral stimulation, but especially oral fat exposure, elevates serum triglycerides in humans
Mattes
Am. J. Physiol. Gastrointest. Liver Physiol. 2009;296:G365-G371.
ABSTRACT | FULL TEXT  

Gestational age and risk factors for cardiovascular disease: evidence from the 1958 British birth cohort followed to mid-life
Cooper et al.
Int J Epidemiol 2009;38:235-244.
ABSTRACT | FULL TEXT  

High-Density Lipoprotein Particle Size and Concentration and Coronary Risk
El Harchaoui et al.
ANN INTERN MED 2009;150:84-93.
ABSTRACT | FULL TEXT  

A Null Mutation in Human APOC3 Confers a Favorable Plasma Lipid Profile and Apparent Cardioprotection
Pollin et al.
Science 2008;322:1702-1705.
ABSTRACT | FULL TEXT  

Fasting and Postprandial Remnant-Like Particle Cholesterol Concentrations in Obese Participants Are Associated with Plasma Triglycerides, Insulin Resistance, and Body Fat Distribution
van Hees et al.
J. Nutr. 2008;138:2399-2405.
ABSTRACT | FULL TEXT  

Nonfasting Triglycerides and Risk of Ischemic Stroke in the General Population
Freiberg et al.
JAMA 2008;300:2142-2152.
ABSTRACT | FULL TEXT  

Fasting and Nonfasting Lipid Levels: Influence of Normal Food Intake on Lipids, Lipoproteins, Apolipoproteins, and Cardiovascular Risk Prediction
Langsted et al.
Circulation 2008;118:2047-2056.
ABSTRACT | FULL TEXT  

ABCA1 Gene Mutations, HDL Cholesterol Levels, and Risk of Ischemic Heart Disease--Reply
Tybjaerg-Hansen et al.
JAMA 2008;300:1998-1998.
FULL TEXT  

The Residual Risk Reduction Initiative: a call to action to reduce residual vascular risk in dyslipidaemic patients
Fruchart et al.
Diabetes and Vascular Disease Research 2008;5:319-335.
ABSTRACT  

Accumulating short bouts of brisk walking reduces postprandial plasma triacylglycerol concentrations and resting blood pressure in healthy young men
Miyashita et al.
Am. J. Clin. Nutr. 2008;88:1225-1231.
ABSTRACT | FULL TEXT  

Fructose consumption and consequences for glycation, plasma triacylglycerol, and body weight: meta-analyses and meta-regression models of intervention studies
Livesey and Taylor
Am. J. Clin. Nutr. 2008;88:1419-1437.
ABSTRACT | FULL TEXT  

Superoxide Dismutase 3 Polymorphism Associated with Reduced Lung Function in Two Large Populations
Dahl et al.
Am. J. Respir. Crit. Care Med. 2008;178:906-912.
ABSTRACT | FULL TEXT  

Investigation and management of hypertriglyceridaemia
Ferns et al.
J. Clin. Pathol. 2008;61:1174-1183.
ABSTRACT | FULL TEXT  

Genetically Elevated C-Reactive Protein and Ischemic Vascular Disease
Zacho et al.
NEJM 2008;359:1897-1908.
ABSTRACT | FULL TEXT  

Pentanucleotide Repeat Polymorphism, Lipoprotein(a) Levels, and Risk of Ischemic Heart Disease
Kamstrup et al.
J. Clin. Endocrinol. Metab. 2008;93:3769-3776.
ABSTRACT | FULL TEXT  

Fasting Compared With Nonfasting Lipids and Apolipoproteins for Predicting Incident Cardiovascular Events
Mora et al.
Circulation 2008;118:993-1001.
ABSTRACT | FULL TEXT  

The effect of n-3 fatty acids on lipids and lipoproteins in patients treated with chronic haemodialysis: a randomized placebo-controlled intervention study
Svensson et al.
Nephrol Dial Transplant 2008;23:2918-2924.
ABSTRACT | FULL TEXT  

Apolipoprotein CIII and Atherosclerosis: Beyond Effects on Lipid Metabolism
Bobik
Circulation 2008;118:702-704.
FULL TEXT  

Lipopolysaccharide associates with pro-atherogenic lipoproteins in periodontitis patients
Kallio et al.
Innate Immunity 2008;14:247-253.
ABSTRACT  

An apolipoprotein A-V gene SNP is associated with marked hypertriglyceridemia among Asian-American patients
Pullinger et al.
J. Lipid Res. 2008;49:1846-1854.
ABSTRACT | FULL TEXT  

Increased Plasma Apolipoprotein C-III Concentration Independently Predicts Cardiovascular Mortality: The Hoorn Study
Scheffer et al.
Clin. Chem. 2008;54:1325-1330.
ABSTRACT | FULL TEXT  

Association of Loss-of-Function Mutations in the ABCA1 Gene With High-Density Lipoprotein Cholesterol Levels and Risk of Ischemic Heart Disease
Frikke-Schmidt et al.
JAMA 2008;299:2524-2532.
ABSTRACT | FULL TEXT  

Abdominal Obesity and the Metabolic Syndrome: Contribution to Global Cardiometabolic Risk
Despres et al.
Arterioscler. Thromb. Vasc. Bio. 2008;28:1039-1049.
ABSTRACT | FULL TEXT  

Metabolic Syndrome and Mortality in Older Adults: The Cardiovascular Health Study
Mozaffarian et al.
Arch Intern Med 2008;168:969-978.
ABSTRACT | FULL TEXT  

Twenty-four-hour endocrine and metabolic profiles following consumption of high-fructose corn syrup-, sucrose-, fructose-, and glucose-sweetened beverages with meals
Stanhope et al.
Am. J. Clin. Nutr. 2008;87:1194-1203.
ABSTRACT | FULL TEXT  

Susceptibility to coronary artery disease and diabetes is encoded by distinct, tightly linked SNPs in the ANRIL locus on chromosome 9p
Broadbent et al.
Hum Mol Genet 2008;17:806-814.
ABSTRACT | FULL TEXT  

Association of serum lipid indices with large artery atherosclerotic stroke
Bang et al.
Neurology 2008;70:841-847.
ABSTRACT | FULL TEXT  

The year in atherothrombosis.
Sanz et al.
J Am Coll Cardiol 2008;51:944-955.
FULL TEXT  

Effects of a 1,3-diacylglycerol oil-enriched diet on postprandial lipemia in people with insulin resistance
Reyes et al.
J. Lipid Res. 2008;49:670-678.
ABSTRACT | FULL TEXT  

Impact of metformin versus the prandial insulin secretagogue, repaglinide, on fasting and postprandial glucose and lipid responses in non-obese patients with type 2 diabetes
Lund et al.
Eur J Endocrinol 2008;158:35-46.
ABSTRACT | FULL TEXT  

Fasting versus Nonfasting Triglycerides and the Prediction of Cardiovascular Risk: Do We Need to Revisit the Oral Triglyceride Tolerance Test?
Ridker
Clin. Chem. 2008;54:11-13.
FULL TEXT  

Fasting versus Nonfasting Triglycerides: Implications for Laboratory Measurements
Warnick and Nakajima
Clin. Chem. 2008;54:14-16.
FULL TEXT  

Nonfasting Triglycerides and Cardiovascular Risk
Yancy et al.
JAMA 2007;298:2004-2004.
FULL TEXT  

Nonfasting Triglycerides and Cardiovascular Risk Reply
Ridker
JAMA 2007;298:2005-2006.
FULL TEXT  

Triglycerides and Coronary Heart Disease Revisited (Again)
Criqui
ANN INTERN MED 2007;147:425-427.
FULL TEXT  

Hypertriglyceridemia
Brunzell
NEJM 2007;357:1009-1017.
FULL TEXT  

Are Nonfasting Better Than Fasting Triglyceride Levels at Predicting Cardiac Events?
Journal Watch Cardiology 2007;2007:1-1.
FULL TEXT  

Triglycerides and Risk for Coronary Heart Disease
McBride
JAMA 2007;298:336-338.
FULL TEXT