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Triglyceride conundrum |
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| It has long been held that knowledge of serum triglyceride levels, when combined with measurements of total and subfraction cholesterol levels, directly affects a physician’s ability to predict a patient’s risk of coronary heart disease. But a recent article by researchers at the Veterans Affairs Medical Center (San Francisco) and the University of California at San Francisco suggests that this belief may be unfounded (Arch. Intern. Med. 2000, 160, 1937–1944).
The researchers performed a secondary analysis of three large American cohort studies of serum lipid levels and coronary heart disease. They examined direct influences such as triglyceride, HDL, LDL, and cholesterol levels as well as indirect influences such as smoking, body mass index, and use of postmenopausal hormone. They used fatal and nonfatal heart attacks as outcome measures. Almost without exception, the researchers were unable to find cases in which triglyceride measurements improved the discrimination between patients who did or did not suffer coronary heart disease events. But this result does not mean that serum triglyceride measurements are useless. Abnormal triglyceride metabolism may yet be important in the pathogenesis of atherosclerotic diseases. High triglyceride levels may also indicate diabetes mellitus, obesity, or alcoholism. — |
