Projects per year
Abstract
Aims
It is unclear whether higher triglyceride metabolism per se contributes to mortality separate from elevated triglyceride-rich lipoproteins and body mass index. This study tested the hypotheses that higher triglyceride metabolism, measured as higher plasma glycerol and β-hydroxybutyrate, is associated with increased all-cause, cardiovascular, cancer, and other mortality.
Methods and results
This study included 30 000 individuals nested within 109 751 individuals from the Copenhagen General Population Study. During a median follow-up of 10.7 years, 9897 individuals died (2204 from cardiovascular, 3366 from cancer, and 2745 from other causes), while none were lost to follow-up. In individuals with glycerol >80 µmol/L (highest fourth) vs. individuals with glycerol <52 µmol/L (lowest fourth), the multivariable adjusted hazard ratio for all-cause mortality was 1.31 (95% confidence interval 1.22–1.40). In individuals with β-hydroxybutyrate >154 µmol/L (highest fourth) vs. individuals with β-hydroxybutyrate <91 µmol/L (lowest fourth), the multivariable adjusted hazard ratio for all-cause mortality was 1.18 (1.11–1.26). Corresponding values for higher plasma glycerol and β-hydroxybutyrate were 1.37 (1.18–1.59) and 1.18 (1.03–1.35) for cardiovascular mortality, 1.24 (1.11–1.39) and 1.16 (1.05–1.29) for cancer mortality, and 1.45 (1.28–1.66) and 1.23 (1.09–1.39) for other mortality, respectively. Results were robust to exclusion of first years of follow-up, to stratification for covariates including plasma triglycerides and body mass index, and to further adjustments.
Conclusion
This study observed an increased risk of all-cause, cardiovascular, cancer, and other mortality with higher triglyceride metabolism. This was not explained by higher plasma triglycerides and body mass index. The hypothesis studied in the present paper should be further validated by isotope flux studies.
It is unclear whether higher triglyceride metabolism per se contributes to mortality separate from elevated triglyceride-rich lipoproteins and body mass index. This study tested the hypotheses that higher triglyceride metabolism, measured as higher plasma glycerol and β-hydroxybutyrate, is associated with increased all-cause, cardiovascular, cancer, and other mortality.
Methods and results
This study included 30 000 individuals nested within 109 751 individuals from the Copenhagen General Population Study. During a median follow-up of 10.7 years, 9897 individuals died (2204 from cardiovascular, 3366 from cancer, and 2745 from other causes), while none were lost to follow-up. In individuals with glycerol >80 µmol/L (highest fourth) vs. individuals with glycerol <52 µmol/L (lowest fourth), the multivariable adjusted hazard ratio for all-cause mortality was 1.31 (95% confidence interval 1.22–1.40). In individuals with β-hydroxybutyrate >154 µmol/L (highest fourth) vs. individuals with β-hydroxybutyrate <91 µmol/L (lowest fourth), the multivariable adjusted hazard ratio for all-cause mortality was 1.18 (1.11–1.26). Corresponding values for higher plasma glycerol and β-hydroxybutyrate were 1.37 (1.18–1.59) and 1.18 (1.03–1.35) for cardiovascular mortality, 1.24 (1.11–1.39) and 1.16 (1.05–1.29) for cancer mortality, and 1.45 (1.28–1.66) and 1.23 (1.09–1.39) for other mortality, respectively. Results were robust to exclusion of first years of follow-up, to stratification for covariates including plasma triglycerides and body mass index, and to further adjustments.
Conclusion
This study observed an increased risk of all-cause, cardiovascular, cancer, and other mortality with higher triglyceride metabolism. This was not explained by higher plasma triglycerides and body mass index. The hypothesis studied in the present paper should be further validated by isotope flux studies.
| Original language | English |
|---|---|
| Article number | ehad330 |
| Pages (from-to) | 4174-4182 |
| Number of pages | 9 |
| Journal | European Heart Journal |
| Volume | 44 |
| Issue number | 39 |
| Early online date | 14 Aug 2023 |
| DOIs | |
| Publication status | Published - 14 Oct 2023 |
Bibliographical note
Funding Information:The study was funded by the Independent Research Fund, Denmark [grant no:9039-00360B to BGN], and by Johan Boserup and Lise Boserups Grant [grant no: 20795-24 to MØJ]. G.D.S. and NMR processing costs were supported by the Medical Research Council Integrative Epidemiology Unit at the University of Bristol MC_UU_00011/1. G.D.S. reports Scientific Advisory Board Membership for Relation Therapeutics and Insitro. Funders had no role in study design, data collection, data analysis, data interpretation, writing of the report, or in the decision to submit the paper for publication.
Publisher Copyright:
© 2023 The Author(s). Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved.
Research Groups and Themes
- Bristol Population Health Science Institute
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- 1 Finished
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IEU: MRC Integrative Epidemiology Unit Quinquennial renewal
Gaunt, L. F. (Principal Investigator) & Davey Smith, G. (Principal Investigator)
1/04/18 → 31/03/23
Project: Research