Data_Sheet_1_Association between hypertriglyceridemic-waist phenotype and cardiovascular disease: A cohort study and meta-analysis.docx

BackgroundThe association between hypertriglyceridemic-waist (HTGW) phenotype and cardiovascular disease (CVD) remains inconsistent and debatable. We aimed to prospectively investigate the relationship between HTGW phenotype and CVD.
Methods and resultsWe included 8,216 participants from the China Health and Retirement Longitudinal Study. Participants were categorized into four subgroups: NTNW: normal triglyceride levels and normal waist circumference; HTNW: high triglyceride levels and normal waist circumference; NTGW: normal triglyceride levels with enlarged waist circumference; HTGW: high triglyceride levels and enlarged waist circumference. A Cox proportional hazards model was applied to determine the association between HTGW phenotype and CVD. A meta-analysis was conducted to incorporate the results of the current study and the previous-related studies on the association of HTGW phenotype and CVD. In the present cohort study, compared to the NTNW phenotype, those with NTGW (Hazard ratios (HRs) 1.34, 95% confidence intervals (CIs) 1.16–1.55) and HTGW (HRs 1.37, 95% CIs 1.16–1.62) phenotype were significantly associated with CVD risk. The meta-analysis further confirmed the significant association between HTGW phenotype and CVD [the pooled relative risk for HTGW vs. NTNW was 1.39 (1.29–1.49)].
ConclusionThe HTGW phenotype was associated with the increased risk of CVD, independently of established risk factors. A simple assessment of HTGW phenotypes might help to identify individuals with a high risk of developing CVD.

研究背景 高甘油三酯血症-腰围表型（hypertriglyceridemic-waist phenotype, HTGW）与心血管疾病（cardiovascular disease, CVD）之间的关联迄今仍存在不一致性与争议。本研究旨在前瞻性探究HTGW表型与CVD的关联。
方法与结果 本研究纳入中国健康与养老追踪调查（China Health and Retirement Longitudinal Study）的8216名受试者。将受试者分为四个亚组：NTNW：甘油三酯水平正常且腰围正常；HTNW：甘油三酯水平升高且腰围正常；NTGW：甘油三酯水平正常且腰围增大；HTGW：甘油三酯水平升高且腰围增大。采用Cox比例风险模型（Cox proportional hazards model）分析HTGW表型与CVD的关联；同时开展荟萃分析（meta-analysis），整合本研究结果与既往相关研究中HTGW表型与CVD的关联数据。在本队列研究中，与NTNW表型相比，NTGW表型的风险比（Hazard ratios, HR）为1.34，95%置信区间（confidence intervals, CI）为1.16~1.55；HTGW表型的HR为1.37，95%CI为1.16~1.62，二者均与CVD风险显著升高相关。荟萃分析进一步证实了HTGW表型与CVD的显著关联：HTGW相较于NTNW的合并相对风险为1.39（95%CI：1.29~1.49）。
结论 HTGW表型与CVD风险升高显著相关，且独立于已确立的心血管疾病危险因素。对HTGW表型进行简易评估，或有助于识别CVD发病高风险人群。