Hypertriglyceridemic waist phenotype is associated with left ventricular hypertrophy in Chinese hypertension patients

The long-term impact of hypertriglyceridemia-waist phenotype on major adverse cardiovascular events in elderly patients with OSA

INTRODUCTION

The hypertriglyceridemia-waist (HTGW) phenotype is a prevalent risk factor for cardiovascular diseases and obstructive sleep apnea (OSA). However, the impactof the HTGW phenotype on the simultaneous occurrence of OSA and cardiovascular diseases remains unexplored. This study aimed to determine whether the HTGW phenotype elevates the incidence of major adverse cardiovascular events (MACE) in patients with OSA, such as hospitalization for unstable angina and heart failure, myocardial infarction, and cardiovascular death, in patients with OSA.

METHODS

A total of 1,290 patients with OSA were recruited from six hospitals for follow-up. According to the Chinese population criteria recommended by the International Diabetes Federation, the patients were divided into four groups: normal triglyceride waist circumference (NTNW) phenotype, pure high triglyceride (HTNW) phenotype, pure high waist circumference (NTGW) phenotype, and HTGW phenotype. The prognosis for MACE was evaluated using Cox proportional hazards analysis. The prognosis of MACE was evaluated using Cox proportional hazards analysis.

RESULTS

207 (17.9%) developed an HTGW phenotype. After a median of 42 months of follow-up, 119 (10.3%) experienced MACE. Cox proportional hazards analysis revealed that patients exhibiting the HTGW phenotype had a 1.963-fold higher risk of developing MACE than patients with the NTNW phenotype (P = 0.012). These results remained significant after adjusting for confounders, and a 2.186-fold increased risk of MACE was found in patients with NTGW phenotype (P = 0.012). Subgroup analyses revealed an increased risk of MACE in OSA patients with HTGW phenotype and NTGW phenotype that were older than or equal to 70 years, male, and had moderate-to-severe OSA (all P-values < 0.05).

CONCLUSION

The HTGW and NTGW phenotypes significantly increase MACE risk among elderly patients with OSA.

The Hypertriglyceridemic Waist Phenotype is Associated with an Adverse Cardiometabolic Profile in this Cohort of Nigerians

Background

The hypertriglyceridemic waist (HTGW) phenotype was introduced as a means of identifying individuals at risk of developing metabolic syndrome as well as cardiovascular diseases and diabetes. However, studies surrounding the prevalence of the phenotype and its relationship with established markers of cardiometabolic risk, especially in the Nigerian population, remain sparse. This study aimed to determine the prevalence of the HTGW phenotype and explore its relationship with cardiovascular risk markers, namely Castelli Risk Indices I and II (CRI-I and CRI-II), Atherogenic Index of Plasma (AIP) and serum triglyceride-HDL cholesterol ratio (TG/HDL).

Methodology

In this retrospective cross-sectional study, the records of 206 patients presenting at a cardiac hospital from November 2022 to October 2023 were analysed. The HTGW phenotype was deemed present with a waist circumference of at least 94cm in men or 80cm in women and a serum triglyceride level of 150mg/dl or more in both sexes.

Results

At-risk waist circumference was more prevalent in women (92.7% vs 77.3%; p=0.002). The prevalence of the HTWG phenotype in the patient cohort was 29.6%, with more males than females (31.8% vs 27.1%) presenting with the phenotype (p=0.004). Patients with the phenotype also had higher systolic blood pressure, waist circumference, body mass index, triglycerides, AIP, and TG/HDL (all p<0.0005). The HTWG phenotype was also associated with a lower HDL and LDL cholesterol (p<0.0005) as well as a lower CRI-II (p=0.049).

Conclusion

The HTWG phenotype correlates with an increased cardiometabolic risk among Nigerians. This finding warrants the implementation of routine anthropometric and serum triglyceride measurements in screening programmes and hospitals for the early detection of individuals at risk of developing cardiovascular diseases.

Relationship Between Asymptomatic Hyperuricemia and the Hypertriglyceridemic-Waist Phenotype in Korean Adults: A Cross-Sectional Study

Purpose

Visceral fat accumulation can negatively affect uric acid metabolism in healthy adults. The hypertriglyceridemic-waist (HTGW) phenotype is a predictor of diabetes and cardiometabolic risk. This study aimed to investigate the association between the HTGW phenotype and asymptomatic hyperuricemia in Korean adults.

Patients and Methods

The study included 23,240 adults, aged 20-80 years who underwent comprehensive health examinations at a general hospital in Gyeonggi Province, Korea, from January 2020 to December 2022. The HTGW phenotype was defined as the simultaneous presence of elevated serum triglyceride (TG) levels and increased waist circumference (WC). The diagnostic capability of the HTGW phenotype for hyperuricemia and its association with the condition were assessed using the receiver operating characteristic (ROC) curve and logistic regression analysis.

Results

The prevalence of hyperuricemia in the HTGW phenotype was 3.44 times higher than that in the normal TG normal waist (NTNW) phenotype. Compared with those in the NTNW group, the hazard ratios for developing hyperuricemia in the HTGW group were 2.887 (2.566-3.249, P <0.001) for men and 7.341 (5.139-10.487, P <0.001) for women, and these values remained significant after adjusting for potential confounders. The stratified analysis revealed that the HTGW phenotype, coupled with diabetes, had the highest probability of developing asymptomatic hyperuricemia (2.55 times). ROC curve analysis revealed that the area under the curve values of the WC*TG index for hyperuricemia diagnosis were 0.702, 0.627, and 0.685 for all participants, men, and women, respectively.

Conclusion

Among Korean adults, the HTGW phenotype was closely related to hyperuricemia in both men and women and showed a particularly strong association in patients with diabetes. It may be used in combination with an indicator that can complement its accuracy for identifying individuals at high risk of hyperuricemia.