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Understanding the underpinning of hypertriglyceridemia as a risk factor for atherosclerosis
Session:
SESSÃO DE COMUNICAÇÕES ORAIS 01– DOS LÍPIDOS AOS GENES - FATORES DE RISCO E BIOLOGIA MOLECULAR NA ATEROSCLEROSE E SAÚDE CARDIOVASCULAR
Speaker:
Matilde Ferreira
Congress:
CPC 2025
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
12. Coronary Artery Disease (Chronic)
Subtheme:
12.5 Coronary Artery Disease – Prevention
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Matilde Ferreira; Isabel Mendonça; Débora Sá; Francisco Sousa; Gonçalo Abreu; João Adriano Sousa; Eva Henriques; Mariana Rodrigues; Sónia Freitas; António Drumond; Ana Célia Sousa; Roberto Palma Dos Reis
Abstract
<p style="text-align:justify">Introduction: Hypertriglyceridemia (HTG) is considered a risk factor for atherosclerosis and may sometimes be a monogenic condition. However, in most patients, this is due to the cumulative effect of multiple genetic risk variants along with lifestyle factors, medications, and disease conditions. Understanding the genetic and environmental basis of HTG could open new translational opportunities in clinical decisions that are not always consensual.</p> <p style="text-align:justify">Objective: Investigate the main risk factors, lifestyle and genetics, for hypertriglyceridemia during an extensive follow-up in a Portuguese population.</p> <p style="text-align:justify">Methods: A prospective study was conducted on 3,157 enrolled participants from our Research Center dataset, and they were grouped into two categories based on the triglyceride levels, below or above 150 mg/dl in admission. An additive genetic risk score (GRS) was constructed using the variants from the lipidic axis and stratified into terciles. A non-parametric Spearman test evaluated the correlation between triglycerides and continuous GRS. The Kruskal-Wallis test investigated triglycerides median differences in the GRS terciles. Multivariate logistic regression entering GRS and adjusted to all confounders (CAD family history, sedentary lifestyle, alcohol abuse, smoking, type 2 diabetes, hypertension and body mass index BMI≥30kg/m2) investigated variables independently associated with high triglyceride levels.</p> <p style="text-align:justify">Results: A Spearman correlation between triglycerides levels and continuous GRS was positive and highly significant (p<0.0001). Median triglycerides levels of 126 mg/dL, 132 mg/dL and 133 mg/dL were obtained for the GRS 1st, 2nd and 3rd terciles, respectively (p<0.0001). After multivariate regression, entering additive GRS adjusted for all confounder variables, the 2ndtercile of GRS presented an OR of high triglycerides of 1.29 (p=0.005) and 3rdtercile an OR of 1.23 (p=0.028), as well as sedentary lifestyle (p=0.001), alcohol abuse (p=0.005), smoking (p<0.0001), diabetes (p<0.0001), hypertension (p<0.0001) and BMI≥30 (p=0.020).</p> <p style="text-align:justify">Conclusion: In our population, genetic loci identified in GWAS and gathered in a lipidic GRS influenced the high triglyceride levels as well as some clinical conditions (diabetes, hypertension and obesity) and lifestyle as sedentarism, alcohol abuse, and smoking. A healthy lifestyle, with weight loss without smoking and alcohol and appropriate medication, could protect against genetic susceptibility in reducing triglyceride levels.</p>
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