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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EA simple and inexpensive risk assessment tool that incorporates waist circumference and triglyceride level may help to identify patients who are at increased risk of coronary artery disease (CAD), according to new findings from the European Prospective Investigation into Cancer [EPIC]-Norfolk cohort study.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EObesity\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiometabolic Disorder\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EA simple and inexpensive risk assessment tool that incorporates waist circumference and triglyceride level may help to identify patients who are at increased risk of coronary artery disease (CAD), according to new findings from the European Prospective Investigation into Cancer (EPIC)-Norfolk cohort study. Benoit Arsenault, PhD, Universit\u00e9 Laval, Qu\u00e9bec, Canada, described findings from the EPIC-Norfolk study and the emerging role of the hypertriglyceridemic waist phenotype as a marker for CAD risk.\u003C\/p\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n         \u003Ch2 class=\u0022\u0022\u003EAbdominal Obesity as a Risk Factor for CVD\u003C\/h2\u003E\n         \u003Cp id=\u0022p-3\u0022\u003EObesity is increasingly recognized as an important risk factor for cardiovascular disease (CVD). As a common measure of obesity, body mass index (BMI) predicts CVD risk. However, not every individual with an elevated BMI carries excess visceral adipose tissue, which appears to be the most important source of risk factors, such as insulin resistance, elevated triglycerides, low high-density lipoprotein (HDL) levels, and hypertension. At any given BMI, greater levels of accumulated visceral fat are associated with a worse cardiometabolic risk profile and increased mortality risk.\u003C\/p\u003E\n         \u003Cp id=\u0022p-4\u0022\u003EResearchers have proposed the hypertriglyceridemic waist phenotype as a potential risk assessment tool that accounts for abdominal obesity and its associated metabolic changes. For men, the hypertriglyceridemic waist phenotype is defined as a waist circumference of 90 cm (35.4 inches) or more and a triglyceride level of 2.0 mmol\/l (177 mg\/dL) or more. For women, the criteria for the hypertriglyceridemic waist phenotype are a waist circumference of at least 85 cm (33.5 inches) and a triglyceride level of at least 1.5 mmol\/l (133 mg\/dL).\u003C\/p\u003E\n         \u003Cp id=\u0022p-5\u0022\u003EIn the current study, Prof. Arsenault and colleagues examined the association between the hypertriglyceridemic waist phenotype and CAD risk and whether the phenotype could improve risk prediction beyond traditional CVD risk factors. The EPIC-Norfolk cohort analysis included 21,787 men and women aged 45 to 79 years who were followed for a mean of 9.8 years [Arsenault BJ et al. \u003Cem\u003ECMAJ\u003C\/em\u003E 2010].\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-2\u0022\u003E\n         \u003Ch2 class=\u0022\u0022\u003EThe Hypertriglyceridemic Waist Phenotype and CAD Risk\u003C\/h2\u003E\n         \u003Cp id=\u0022p-6\u0022\u003EPatients with the hypertriglyceridemic waist phenotype had an altered cardiometabolic risk profile compared with men and women with normal waist and\/or triglyceride measures. In particular, the hypertriglyceridemic waist phenotype was associated with:\u003C\/p\u003E\n         \u003Cul class=\u0022list-unord \u0022 id=\u0022list-1\u0022\u003E\u003Cli id=\u0022list-item-1\u0022\u003E\n               \u003Cp id=\u0022p-7\u0022\u003EHigher systolic blood pressure levels (p\u0026lt;0.001)\u003C\/p\u003E\n            \u003C\/li\u003E\u003Cli id=\u0022list-item-2\u0022\u003E\n               \u003Cp id=\u0022p-8\u0022\u003EHigher apolipoprotein B levels (p\u0026lt;0.001)\u003C\/p\u003E\n            \u003C\/li\u003E\u003Cli id=\u0022list-item-3\u0022\u003E\n               \u003Cp id=\u0022p-9\u0022\u003EHigher C-reactive protein levels (p\u0026lt;0.001)\u003C\/p\u003E\n            \u003C\/li\u003E\u003Cli id=\u0022list-item-4\u0022\u003E\n               \u003Cp id=\u0022p-10\u0022\u003ELower HDL levels (p\u0026lt;0.001)\u003C\/p\u003E\n            \u003C\/li\u003E\u003Cli id=\u0022list-item-5\u0022\u003E\n               \u003Cp id=\u0022p-11\u0022\u003ELower apolipoprotein A-I levels (p\u0026lt;0.001)\u003C\/p\u003E\n            \u003C\/li\u003E\u003Cli id=\u0022list-item-6\u0022\u003E\n               \u003Cp id=\u0022p-12\u0022\u003ESmaller low-density lipoprotein particles (p\u0026lt;0.001)\u003C\/p\u003E\n            \u003C\/li\u003E\u003C\/ul\u003E\n         \u003Cp id=\u0022p-13\u0022\u003EIncreased waist circumference and elevated triglyceride levels significantly predicted risk of CAD. Men with the hypertriglyceridemic waist phenotype were more than twice as likely to develop CAD as men who did not have the phenotype (HR, 2.40; 95% CI, 2.02 to 2.87). The risk for CAD increased more than 3-fold for women with the hypertriglyceridemic waist phenotype compared with women who did not have the phenotype (HR, 3.84; 95% CI, 3.20 to 4.62).\u003C\/p\u003E\n         \u003Cp id=\u0022p-14\u0022\u003ECompared with normal values, the presence of either an increased waist circumference or hypertriglyceridemia reduced the probability of survival without CAD among both men and women. However, the presence of both an increased waist circumference and an elevated triglyceride level was associated with the worst disease-free survival (p\u0026lt;0.001) for both men and women.\u003C\/p\u003E\n         \u003Cp id=\u0022p-15\u0022\u003EBy providing additional information about excess abdominal adiposity and associated metabolic abnormalities, the hypertriglyceridemic waist phenotype could have the potential to improve traditional CVD risk assessment tools. In the current analysis, Prof. Arsenault and colleagues evaluated the risk of coronary heart disease (CHD) according to Framingham risk scores and the hypertriglyceridemic waist phenotype. Even among men and women with the lowest Framingham risk score (\u226410%), those with the hypertriglyceridemic waist phenotype were at greater risk of CHD than those without the phenotype.\u003C\/p\u003E\n         \u003Cp id=\u0022p-16\u0022\u003EEven though the hypertriglyceridemic waist phenotype is a robust marker of abdominal obesity, it can not be used on its own to fully assess a patient\u0027s risk of CAD, Prof. Arsenault said. Instead, the phenotype should be used together with existing CVD risk prediction algorithms, such as the Framingham risk score, to provide a better assessment of global cardiometabolic risk.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2011 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/11\/2\/15.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzn43e\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}