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Some studies suggest that normal triglyceride levels are associated with cognitive function and vary by age, sex, and weight, while other studies indicate that these levels may still pose risks for coronary events and systemic inflammation.
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Research has shown that triglyceride (TG) levels previously considered "normal" can still predict new coronary artery disease (CAD) events. A study involving 740 patients found that those with TG levels above 100 mg/dL had a higher risk of CAD events compared to those with lower levels. Specifically, TG levels ≥100 mg/dL were associated with a 1.5 times higher risk of CAD events. This suggests that the current cutpoints for elevated TGs, as defined by the National Cholesterol Education Program, may need to be refined.
Another study highlighted that even "normal" TG levels (100-149 mg/dL) are associated with systemic inflammation, as indicated by elevated C-reactive protein (CRP) levels. This association remained significant even after adjusting for other covariates, suggesting that TG levels below 100 mg/dL might be more optimal for assessing coronary heart disease (CHD) risk.
Interestingly, high normal plasma triglycerides have been associated with preserved cognitive function in the oldest-old population in China. A study involving 836 subjects aged 80 and older found that higher TG levels were significantly associated with lower odds of cognitive impairment. Specifically, those in the highest quartile of TG levels had a 48% reduced risk of cognitive impairment compared to those in the lowest quartile. This suggests a potential protective role of higher normal TG levels in cognitive health among the elderly.
In healthy adults, serum triglyceride levels vary with age and gender. Studies have shown that males aged 40-49 years tend to have higher TG levels compared to other age groups, while females do not exhibit significant age-related variations. Overweight individuals, particularly males, also tend to have higher TG levels compared to those of normal weight .
Non-fasting TG levels also provide valuable insights. Research on healthy Dutch males and females revealed that non-fasting TG levels are generally higher in the evening. The majority of subjects had TG levels below 4.6 mmol/L in the evening, with 75% having levels below 2.9 mmol/L for males and 2.2 mmol/L for females. These findings help delineate normal ranges of non-fasting TG levels and could be used to identify individuals at risk for atherosclerosis.
In patients with established coronary heart disease, higher TG levels are independently associated with increased long-term mortality. A 22-year follow-up study found that patients with TG levels between 100-149 mg/dL had a higher risk of death compared to those with lower levels. The risk increased progressively with higher TG levels, with severe hypertriglyceridemia (≥500 mg/dL) being associated with a 68% increased risk of mortality.
Normal triglyceride levels, traditionally considered safe, can still pose significant health risks, particularly concerning coronary artery disease and systemic inflammation. However, higher normal TG levels may have a protective effect on cognitive function in the elderly. Understanding these nuances is crucial for refining current guidelines and improving risk assessment and management strategies for various health conditions.
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