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Abstract
To determine the relation between plasma triglyceride levels and the risk of incident
cardiovascular disease, the semiquantitative techniques of meta-analysis were applied
to 17 population-based prospective studies of triglyceride and cardiovascular disease.
Sixteen of these studies represented 2,445 events among 46,413 Caucasian men followed
for an average period of 8.4 years, and 5 studies represented 439 events among 10,864
Caucasian women followed for an average period of 11.4 years. Univariate relative
risk (RR) estimates for incident cardiovascular disease associated with a 1-mmol/L
increase in triglyceride was 1.07-1.98 in men, with a summary RR of 1.32 (95% confidence
interval [CI]: 1.26-1.39), indicating a 32% increase in disease risk associated with
increased triglyceride. In the studies involving women, individual RR estimates for
triglyceride were 1.69-2.05, with a summary RR of 1.76 (95% CI: 1.50-2.07), indicating
a 76% increase in disease risk associated with increased triglyceride. After adjustment
for high-density lipoprotein cholesterol and other risk factors, these risks were
decreased to 14% in men and 37% in women but remained statistically significant. Three
recent prospective epidemiologic studies have also shown that plasma triglyceride
and low-density lipoprotein particle size predict subsequent coronary artery disease
in Caucasian populations. Taken together, these studies demonstrate the importance
of triglyceride levels as a risk factor for cardiovascular disease.