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

Liu J, Zeng FF, Liu ZM, Zhang CX, Ling WH, Chen YM - Lipids Health Dis (2013)

Bottom Line: 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.Twelve and fourteen studies, respectively, reported the effects estimates of CVDs and total mortality by TG categories.In conclusion, elevated blood TG levels were dose-dependently associated with higher risks of CVDs and all-cause mortality.

View Article: PubMed Central - HTML - PubMed

Affiliation: Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, People's Republic of China. chenyum@mail.sysu.edu.cn.

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.

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Flow diagram of study selection. TG: Triglycerides; CVDs: Cardiovascular diseases
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Figure 1: Flow diagram of study selection. TG: Triglycerides; CVDs: Cardiovascular diseases

Mentions: Figure 1 outlines our search and selection process, and illustrates the detailed population selection criteria in the original studies. A total of 61 studies included in the present meta-analysis were pooled according to CVDs mortality and all-cause mortality. They were all published in English with the exception of one published in Norwegian study [21]. The features of these studies are summarized in Additional file 1: Table S1. Thirty-three studies reported data on CVDs mortality; together recording 17,018 CVDs deaths in 726,030 participants; and 38 studies reported data on all-cause mortality, together recording 58,419 deaths in 330,566 participants. The median age at the recruitment was 48.0 and median duration of follow-up was 12.0 years.


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

Liu J, Zeng FF, Liu ZM, Zhang CX, Ling WH, Chen YM - Lipids Health Dis (2013)

Flow diagram of study selection. TG: Triglycerides; CVDs: Cardiovascular diseases
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4231478&req=5

Figure 1: Flow diagram of study selection. TG: Triglycerides; CVDs: Cardiovascular diseases
Mentions: Figure 1 outlines our search and selection process, and illustrates the detailed population selection criteria in the original studies. A total of 61 studies included in the present meta-analysis were pooled according to CVDs mortality and all-cause mortality. They were all published in English with the exception of one published in Norwegian study [21]. The features of these studies are summarized in Additional file 1: Table S1. Thirty-three studies reported data on CVDs mortality; together recording 17,018 CVDs deaths in 726,030 participants; and 38 studies reported data on all-cause mortality, together recording 58,419 deaths in 330,566 participants. The median age at the recruitment was 48.0 and median duration of follow-up was 12.0 years.

Bottom Line: 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.Twelve and fourteen studies, respectively, reported the effects estimates of CVDs and total mortality by TG categories.In conclusion, elevated blood TG levels were dose-dependently associated with higher risks of CVDs and all-cause mortality.

View Article: PubMed Central - HTML - PubMed

Affiliation: Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, People's Republic of China. chenyum@mail.sysu.edu.cn.

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.

Show MeSH
Related in: MedlinePlus