Several previous studies have indicated that high levels of nonfasting triglycerides are associated with the increased risk of developing cardiac ailments such as ischemic heart disease. Now, a recent study published in the journal JAMA suggests that elevated nonfasting triglycerides also enhance the risk of ischemic stroke.

Jacob J Freiberg from the Department of Clinical Biochemistry, Herlev Hospital, Denmark, and colleagues, conducted a prospective Danish population-based cohort study, involving 13,956 men and women (20 and 93 years old) during the period 1976 to 2007, to determine the relationship between high levels of nonfasting triglycerides and increased risk of ischemic stroke. A cross-sectional study inclusive of 9637 participants attending the prospective study from 1991 to 1994 was also conducted. The prospective study results showed that ischemic stroke occurred in 1,529 of the 13,956 participants, with the cumulative incidence of ischemic stroke directly proportional to the levels of the nonfasting triglycerides. Multivariate-hazard ratios (HRs) for ischemic stroke in relation to elevated nonfasting triglyceride levels for both sexes are presented in the table.

The absolute 10-year risk for ischemic stroke varied between 2.6% in men aged <55 years with nonfasting triglyceride level of <89 mg/dL to 16.7% in those aged >55 years with levels of >443 mg/dL, and corresponding values of 1.9% and 12.2% in women. In the cross sectional study, the nonfasting triglyceride levels in men and women who had previous ischemic stroke were 191 mg/dL, and167 mg/dL, respectively. Based on the study findings, the researchers concluded that higher nonfasting triglyceride levels were associated with enhanced risk of ischemic stroke.

Previously, Bansal, et al. (JAMA, 2007) conducted a prospective study on 26,509 (20,118 fasting and 6,391 nonfasting) initially healthy US women enrolled between 1992-1995, to examine the link between triglyceride levels (fasting vs nonfasting) and risk for future cardiovascular events. The subjects, followed for a median of 11.4 years, demonstrated an incident cardiovascular event in 1,001 participants, which included 265 ischemic strokes, 275 nonfatal myocardial infarctions, 165 cardiovascular deaths and 628 coronary revascularization cases. In contrast to fasting triglyceride levels, 2-4 hour postprandial triglyceride levels demonstrated the strongest relationship with cardiovascular events like myocardial infarction and stroke, independent of other traditional cardiovascular risk factors and other lipids levels.

Ischemic stroke, one of the leading causes of long-term disability, comprises of 90% of all strokes that occur each year in the United States. Some of the warning signs of stroke include unilateral weakness of face, arm or leg, trouble speaking or seeing, sudden confusion, and unexplained severe headache. According to the Centers for Disease Control and Prevention (CDC), stroke is the third leading cause of death in the US, with more than 150,000 deaths reported annually.

With the current research demonstrating the potential of postprandial triglyceride estimation in determining the risk of stroke, elevated levels of nonfasting triglycerides could serve as a predictor of both cardiovascular and cerebrovascular risks.

References

1. Freiberg JJ, Tybjaerg-Hansen A, Jensen JS, et al. Nonfasting triglycerides and risk of ischemic stroke in the general population. JAMA. 2008 Nov 12;300(18):2142-52.

2. Bansal S, Buring JE, Rifai N, Mora S, Sacks FM, Ridker PM. Fasting compared with nonfasting triglycerides and risk of cardiovascular events in women. JAMA. 2007 Jul 18;298(3):309-16.