Evaluating CMR

Metabolic Syndrome and Type 2 Diabetes/CVD Risk

Usefulness of Hypertriglyceridemic Waist

Hypertriglyceridemic Waist Predicts Metabolic Abnormalities

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Hypertriglyceridemic waist can also be useful in clinical practice to detect individuals likely to have features of the metabolic syndrome, such as an elevated cholesterol/HDL cholesterol ratio, postprandial hyperlipidemia, hyperinsulinemia, and a dyslipidemic profile typically found in subjects with abdominal obesity. In this regard, Solati et al. (13) reported that 75% of men of the Tehran Lipid and Glucose Study with hypertriglyceridemic waist had four to six risk factors (cholesterol, LDL cholesterol, HDL cholesterol, systolic blood pressure, diastolic blood pressure, and BMI). Other studies have also validated the ability of hypertriglyceridemic waist to identify individuals at high risk of CVD (11, 15, 18-21). Lamonte et al. (11) have published evidence that more than two-thirds of women with elevated waist girth and triglyceride concentrations also had hyperinsulinemia as well as increased apolipoprotein B and LDL cholesterol levels. Furthermore, a clear relationship between hypertriglyceridemic waist and the cholesterol/HDL cholesterol ratio, a well-known strong predictor of CHD (29, 30), has been reported in several study populations (10, 14, 18, 21). The prevalence of subjects with a cholesterol/HDL cholesterol ratio ≥ 6 was almost 50%, whereas it was only 3% among men with both low waist girth and normal triglyceride concentrations (10). Carriers of the hypertriglyceridemic waist phenotype also have deteriorated plasma glucose-insulin homeostasis compared to individuals without this phenotype (10, 11, 18, 20, 21). In addition, a postprandial study revealed that men with hypertriglyceridemic waist had the greatest increase in triglyceride concentrations during the postprandial state compared to control subjects (15). The latter study also indicated that this phenotype was better at identifying a hyperlipidemic state during the postprandial phase than elevated waist circumference or hypertriglyceridemia measured in isolation.

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