Abstract P022: Hypertriglyceridemic Waist Phenotype is Associated with Elevated Inflammatory Biomarker Levels
Introduction: Hypertriglyceridemic waist (TGW) is an easily identifiable clinical phenotype, reflecting visceral obesity. Inflammatory markers and insulin resistance potentially serve as the genetic link between TGW, accelerated atherogenesis and cardiovascular outcomes. We describe characteristics of patients with TGW and the association between inflammatory biomarkers, insulin resistance and TGW.
Methods: Our sample consisted of 3328 subjects from the National Health and Nutrition Examination Survey III (1988-1994). Subjects who did not have data regarding waist circumference (WC) or fasting serum triglycerides (TG) were excluded. TGW was defined as WC ≥ 90 cm and TG ≥ 176 mg/dl in males and WC ≥ 85 cm and TG ≥ 132 mg/dl in females. Biomarkers studied were serum ferritin, C Reactive protein (CRP), uric acid, fasting insulin and C-peptide. Stata 11 was used to perform T test (using log-transformed variables), Wilcoxon-Mann-Whitney test and logistic regression.
Results: Our data consisted of 51% (1700) males, 56% (1847) Caucasians/16% (537) African Americans, 54% (1791) had hypertension, 12% (406) had diabetes, 38% (1255) had hyperlipidemia and 35% (1169) had TGW. Mean TG was 163+155mg/dl; mean WC was 99+14cm. Patients with TGW were older (61+ 12 vs. 59+13, p<0.001), male (54 vs. 48%, p 0.003), Caucasian (60 vs. 54%, p<0.001), had more hypertension (61 vs. 50%, p<0.001), hyperlipidemia (47 vs. 33%, p<0.001), diabetes (17 vs. 10%, p<0.001). T test and Wilcoxon-Mann-Whitney test revealed ferritin, CRP, uric acid, insulin and C-peptide to be higher among those who had TGW. They predicted TGW after adjustment for age, sex, race, glomerular filtration rate, hypertension, hypertension medications, hyperlipidemia, hyperlipidemia medications, diabetes, end stage renal disease and hemodialysis. (See table 1)
Conclusion: Patients with TGW have worse clinical profiles. Inflammatory biomarkers and insulin resistance are associated with TGW. Genetic studies are required for further evaluation.
|Biomarker||Ferritin (ng/ml)||CRP (mg/dl)||Uric acid (mg/dl)||Insulin (µU/ml)||C peptide (ng/ml)|
|Median (no TGW)||92||0.21||5.3||8.2||0.69|
- © 2012 by American Heart Association, Inc.