Effects of blood triglycerides on cardiovascular and all-cause mortality: a systematic review and meta-analysis of 61 prospective studies

Abstract

The relationship of triglycerides (TG) to the risk of death remains uncertain. The aim of this study was to determine the associations between blood triglyceride levels and cardiovascular diseases (CVDs) mortality and all-cause mortality. Four databases were searched without language restriction for relevant studies: PubMed, ScienceDirect, EMBASE, and Google Scholar. All prospective cohort studies reporting an association between TG and CVDs or all-cause mortality published before July 2013 were included. Risk ratios (RRs) with 95% confidence intervals (CIs) were extracted and pooled according to TG categories, unit TG, and logarithm of TG using a random-effects model with inverse-variance weighting. We identified 61 eligible studies, containing 17,018 CVDs deaths in 726,030 participants and 58,419 all-cause deaths in 330,566 participants. Twelve and fourteen studies, respectively, reported the effects estimates of CVDs and total mortality by TG categories. Compared to the referent (90–149 mg/dL), the pooled RRs (95% CI) of CVDs mortality for the lowest (< 90 mg/dL), borderline-high (150–199 mg/dL), and high TG (≥ 200 mg/dL) groups were 0.83 (0.75 to 0.93), 1.15 (1.03 to 1.29), and 1.25 (1.05 to 1.50); for total mortality they were 0.94 (0.85 to 1.03), 1.09 (1.02 to 1.17), and 1.20 (1.04 to 1.38), respectively. The risks of CVDs and all-cause deaths were increased by 13% and 12% (p < 0.001) per 1-mmol/L TG increment in twenty-two and twenty-two studies reported RRs per unit TG, respectively. In conclusion, elevated blood TG levels were dose-dependently associated with higher risks of CVDs and all-cause mortality.

Risk Factors for Incidence of Cardiovascular Diseases and All-Cause Mortality in a Middle Eastern Population over a Decade Follow-up: Tehran Lipid and Glucose Study

“…Recently, we showed that 1 SD increment in log-transformed TGs was accompanied with 19% lower risk of non-CVD mortality [67]. A contention in contrast with previous studies, which highlighted the linear relation between hypertriglyceridemia and mortality [68, 69]; one explanation would be that low TG could be a marker of malnutrition and weight loss which, in turn, may increase mortality risk in the population [70]. In our study, after CVD, cancer was the most common cause of death and it has been shown that the low TG and weight loss are poor prognostic signs in cancerous patients and are associated with poor survival [48–50, 71].…”

Postprandial lipoprotein profile in two modes of high-intensity intermittent exercise

“…Indeed, triacylglycerol have been associated to 13% and 12% more odds of cardiovascular diseases and all-cause mortality, respectively (Liu et al, 2013). In addition, cardiovascular disease has a significant public health cost (Azambuja et al, 2008; de Oliveira et al, 2012).…”

Antihyperlipidemic activity of adenosine triphosphate in rabbits fed a high-fat diet and hyperlipidemic patients

“…At present, hypertriglyceridemia has become more generally accepted as a risk factor for cardiovascular diseases (CVDs) (Ninomiya et al 2004;Miller et al 2011). A meta-analysis has shown that per 1 mmol/L TG increment increases the risks of CVDs and all-cause deaths by 13% and 12%, respectively (Liu et al 2013). Therefore, controlling TG may help to prevent CVDs and other causes of death.…”