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Relation of the “Hypertriglyceridemic Waist” Phenotype to Earlier Manifestations of Coronary Artery Disease in Patients With Glucose Intolerance and Type 2 Diabetes Mellitus

  • Author Footnotes
    1 Dr. St-Pierre is the recipient of the “Walter & Jessie Boyd & Charles Scriver” MD/PhD Studentship Award from the Canadian Institutes of Health Research (CIHR), Ottawa, Ontario, Canada; the Canadian Genetic Diseases Network, the Canadian Gene Cure Foundation, and Theratechnologies (A. Jean Degrandpré Scholarship Award).
    Julie St-Pierre
    Footnotes
    1 Dr. St-Pierre is the recipient of the “Walter & Jessie Boyd & Charles Scriver” MD/PhD Studentship Award from the Canadian Institutes of Health Research (CIHR), Ottawa, Ontario, Canada; the Canadian Genetic Diseases Network, the Canadian Gene Cure Foundation, and Theratechnologies (A. Jean Degrandpré Scholarship Award).
    Affiliations
    Department of Medicine, Université de Montréal, University of Montreal Community Genomic Medicine Center and Lipid Clinic, Chicoutimi Hospital, Chicoutimi, Québec, Canada

    Québec Heart Institute, Laval Hospital Research Center, Sainte-Foy, Québec, Canada
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  • Isabelle Lemieux
    Affiliations
    Québec Heart Institute, Laval Hospital Research Center, Sainte-Foy, Québec, Canada
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  • Patrice Perron
    Affiliations
    Department of Medicine, Université de Montréal, University of Montreal Community Genomic Medicine Center and Lipid Clinic, Chicoutimi Hospital, Chicoutimi, Québec, Canada

    Sherbrooke University Medical Center, Sherbrooke, Québec, Canada
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  • Diane Brisson
    Affiliations
    Department of Medicine, Université de Montréal, University of Montreal Community Genomic Medicine Center and Lipid Clinic, Chicoutimi Hospital, Chicoutimi, Québec, Canada
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  • Marta Santuré
    Affiliations
    Department of Medicine, Université de Montréal, University of Montreal Community Genomic Medicine Center and Lipid Clinic, Chicoutimi Hospital, Chicoutimi, Québec, Canada
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  • Marie-Claude Vohl
    Affiliations
    Department of Food Sciences and Nutrition, Laval University, Sainte-Foy, Québec, Canada

    Lipid Research Center, Laval University Medical Research Center, Sainte-Foy, Québec, Canada.
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  • Jean-Pierre Després
    Affiliations
    Québec Heart Institute, Laval Hospital Research Center, Sainte-Foy, Québec, Canada

    Department of Food Sciences and Nutrition, Laval University, Sainte-Foy, Québec, Canada
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  • Author Footnotes
    2 Dr. Gaudet was supported by the Canada Research Chair Program.
    Daniel Gaudet
    Correspondence
    Corresponding author: Tel: 418-541-1077; fax: 418-541-1139.
    Footnotes
    2 Dr. Gaudet was supported by the Canada Research Chair Program.
    Affiliations
    Department of Medicine, Université de Montréal, University of Montreal Community Genomic Medicine Center and Lipid Clinic, Chicoutimi Hospital, Chicoutimi, Québec, Canada
    Search for articles by this author
  • Author Footnotes
    1 Dr. St-Pierre is the recipient of the “Walter & Jessie Boyd & Charles Scriver” MD/PhD Studentship Award from the Canadian Institutes of Health Research (CIHR), Ottawa, Ontario, Canada; the Canadian Genetic Diseases Network, the Canadian Gene Cure Foundation, and Theratechnologies (A. Jean Degrandpré Scholarship Award).
    2 Dr. Gaudet was supported by the Canada Research Chair Program.
Published:December 11, 2006DOI:https://doi.org/10.1016/j.amjcard.2006.08.041
      This study tested the hypothesis that the “hypertriglyceridemic waist” phenotype (waist girth >90 cm [35.4 inches] in men and >85 cm [33.5 inches] in women, along with a plasma triglyceride concentration of ≥2.0 mmol/L [177 mg/dl]) as a covariate of metabolic syndrome features (hyperinsulinemia, hyperapolipoprotein B, and small low-density lipoprotein particles), is predictive of premature coronary artery disease (CAD) among patients with glucose intolerance or type 2 diabetes. Glucose intolerance and type 2 diabetes were assessed after an oral glucose tolerance test among 1,190 men and women using the American Diabetes Association criteria. Glycemic control was evaluated using hemoglobin A1c levels. CAD was considered present on the basis of a clinical history of retrosternal pains on exertion, electrophysiologically and clinically documented myocardial infarction, or angiographic evidence of coronary lesions. More than 53% of men (n = 103) with a waist circumference ≥90 cm (35.4 inches) and nearly 80% of women (n = 122) with a waist circumference ≥85 cm (33.5 in.) with triglyceride levels ≥2 mmol/L (177 mg/dl) were diagnosed with glucose intolerance or type 2 diabetes. Survival models revealed that those with glucose intolerance or type 2 diabetes with the “hypertriglyceridemic waist” phenotype experienced their first CAD symptoms 5 years earlier than those without this phenotype. This elevated and earlier risk of CAD was statistically significant (hazard ratio 2.0, 95% confidence interval 1.2 to 3.7, p = 0.02). In conclusion, the “hypertriglyceridemic waist” phenotype, an inexpensive and simple tool identifying subjects with metabolic syndrome features, is a significant marker of CAD manifestations occurring at an earlier age in those with glucose intolerance or type 2 diabetes.
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