A dose-independent association of triglyceride levels with all-cause mortality among adults population

Abstract

Background The relationship between triglyceride (TG) level and the mortality risk of all-cause and cardiovascular disease is not entirely consistent among adults. Methods The present analysis included adult participants from National Health and Nutrition Examination Surveys (NHANES) between the periods 1999–2014. The levels of TG were categorized into < 150, 150–199, 200–250 and ≥ 250 mg/dL respectively. Multivariate Cox regression analysis, stratified analysis and generalized additive model were conducted to reveal the correlation between TG and mortality risk. Results were presented in hazard ratio (HRs) and 95% confidence intervals (CIs). Results There were 18,781 (9130 males, mean age was 45.64 years) participants being included in the analysis. The average follow-up period was 8.25 years, where 1992 (10.61%) cases of all-cause and 421 (2.24%) cardiovascular death have occurred. In the multivariate Cox model, every 1 mg/dL raise in TG has significantly associated with all-cause mortality (HR: 1.08, 95% CI: 1.02, 1.15) but not cardiovascular mortality (HR: 1.10, 95% CI: 0.97, 1.24). When using TG < 150 mg/dL as reference, TG ≥ 250 mg/dL associated with death from all-cause (HR = 1.34, 95% CI: 1.12, 1.60; P = 0.0016 but not cardiovascular death (HR = 1.26, 95% CI: 0.85, 1.88; P = 0.2517). According to smoothing spline plots, the risk of all-cause was the lowest when TG was approximately 135 mg/dL. Conclusion TG might have a dose-independent association with all-cause mortality among adults in United States.

Fasting status modifies the association between triglyceride and all‐cause mortality: A cohort study

“…This study found that, in the whole cohort comprising the fasting and nonfasting subcohorts, triglyceride was associated with all‐cause mortality. This result is consistent with two recent studies which reported similar findings 9,10 . The exact cause of death was not investigated by the current study; however, the result was consistent with previous observations that higher triglyceride was associated with higher mortality from cardiovascular disease 2 and diabetes 11 …”

“…This result is consistent with two recent studies which reported similar findings. 9,10 The exact cause of death was not investigated by the current study; however, the result was consistent with previous observations that higher triglyceride was associated with higher mortality from cardiovascular disease 2 and diabetes. 11 This study found that fasting triglyceride was not associated with all-cause mortality, which is consistent with some previous reports 4,5 but inconsistent with others.…”

“…The situation is similar for non‐fasting triglyceride: nonfasting triglyceride has been found associated 6,7 or not associated with all‐cause mortality 8 . Recently, it was reported that triglyceride was also positively associated with all‐cause mortality when samples with mixed fasting status were used (i.e., some samples were from fasting participants whereas the others were from nonfasting participants) 9,10 …”

The Triglyceride-Glucose Index, an Insulin Resistance Marker, Was Non-linear Associated With All-Cause and Cardiovascular Mortality in the General Population

“…The measurement of serum triglycerides (TG) and total cholesterol (TC) was performed with enzymatic assays. The level of high-density lipoprotein cholesterol (HDL-C) was determined by direct immunoassay or precipitation ( 21 ). If TG was ≤400 mg/dL, low-density lipoprotein cholesterol (LDL-C) was computed by the Friedewald formula ( 22 ).…”

Associations of Hypertriglyceridemia Onset Age With Cardiovascular Disease and All‐Cause Mortality in Adults: A Cohort Study

“…Our findings that new‐onset hypertriglyceridemia significantly increased the risk of all‐cause mortality echoed the results from previous studies, 27 , 28 , 29 but it remains unclear whether age affects the risk of all‐cause mortality associated with hypertriglyceridemia. The National Health and Nutrition Examination Surveys study found no association of elevated triglycerides with all‐cause mortality after age‐stratified analyses, 30 and the Copenhagen City Heart Study showed that the positive correlation between elevated triglycerides and all‐cause mortality disappeared in participants aged ≥55 years. 11 Unlike previous studies, we observed that the risks of all‐cause mortality were significantly higher in the new‐onset hypertriglyceridemia population across the age range, with a stronger association among younger onset.…”