Serum triglyceride: a possible risk factor for ruptured abdominal aortic aneurysm

Background We aimed to determine the relationship between ruptured abdomina l aortic aneurysm (AAA) and serum concentrations of lipids and apolipoprote ins. Methods A cohort of 21 520 men, aged 35-64 years, was recruited from men at tending the British United Provident Association (BUPA) clinic in London fo r a routine medical examination in 1975-1982. Smoking habits, weight, heigh t and blood pressure were recorded at entry. Lipids and apolipoproteins wer e measured in stored serum samples from the 30 men who subsequently died of ruptured AAA and 150 matched controls. Results Triglyceride was strongly related to risk of ruptured AAA. In univa riate analyses the risk in men on the 90th centile of the distribution rela tive to the risk in men on the 10th (RO10-90) was 12 (95% confidence interv al [CI]:3.8-37) for triglyceride, 5.5 (95% CT: 1.8-17) for apolipoprotein B (apoB) (the protein component of low density lipoprotein [LDL]), 0.15 (95% CI: 0.04-0.56) for apo Al (the protein component of high density lipoprote in [HDL]), 3.7 (95% CI : 1.4-9.4) for body mass index and 3.0 (95% CI:1.1-8 .5) for systolic blood pressure. Lipoprotein (a) (Lp(a)) was not a signific ant risk factor (RO10-90 = 1.6, 95% CI:0.6-3.0). Ln multivariate analysis t riglyceride retained its strong association. Conclusion Triglyceride appears to be a strong risk factor for ruptured AAA , although further studies are required to clarify this. If this and other associations are cause and effect, then changing the distribution of risk f actors in the population (by many people stopping smoking and adapting a lo wer saturated fat diet and by lowering blood pressure) could achieve an imp ortant reduction in mortality from ruptured AAA.