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(Circulation. 2000;102:179.)
© 2000 American Heart Association, Inc.

Clinical Investigation and Reports

Hypertriglyceridemic Waist

A Marker of the Atherogenic Metabolic Triad (Hyperinsulinemia; Hyperapolipoprotein B; Small, Dense LDL) in Men?

Isabelle Lemieux, MSc; Agnès Pascot, MSc; Charles Couillard, PhD; Benoît Lamarche, PhD; André Tchernof, PhD; Natalie Alméras, PhD; Jean Bergeron, MD, MSc; Daniel Gaudet, MD, PhD; Gérald Tremblay, MD; Denis Prud’homme, MD, MSc; André Nadeau, MD; Jean-Pierre Després, PhD

From the Quebec Heart Institute, Laval Hospital Research Center; the Lipid Research Center, CHUL Research Center; the Physical Activity Sciences Laboratory, Laval University; the Diabetes Research Unit, CHUL Research Center, Ste-Foy; and the Lipid Clinic, Chicoutimi Hospital, Chicoutimi, Québec, Canada.

Background—The present study tested the hypothesis that simple variables, such as waist circumference and fasting plasma triglyceride (TG) concentrations, could be used as screening tools for the identification of men characterized by a metabolic triad of nontraditional risk factors (elevated insulin and apolipoprotein [apo] B and small, dense LDL particles).

Methods and Results—Results of the metabolic study (study 1) conducted on 185 healthy men indicate that a large proportion (>80%) of men with waist circumference values 90 cm and with elevated TG levels (2.0 mmol/L) were characterized by the atherogenic metabolic triad. Validation of the model in an angiographic study (study 2) on a sample of 287 men with and without coronary artery disease (CAD) revealed that only men with both elevated waist and TG levels were at increased risk of CAD (odds ratio of 3.6, P<0.03) compared with men with low waist and TG levels.

Conclusions—It is suggested that the simultaneous measurement and interpretation of waist circumference and fasting TG could be used as inexpensive screening tools to identify men characterized by the atherogenic metabolic triad (hyperinsulinemia, elevated apo B, small, dense LDL) and at high risk for CAD.

Key Words: apolipoproteins • insulin • lipoproteins • lipids • coronary disease • waist circumference

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