RELATION OF HIGH TG LOW HDL CHOLESTEROL AND LDL CHOLESTEROL TO THE INCIDENCE OF ISCHEMIC-HEART-DISEASE - AN 8-YEAR FOLLOW-UP IN THE COPENHAGEN MALE STUDY

High triglyceride (TG) and low HDL cholesterol (HDL-C) is the characte ristic dyslipidemia seen in insulin-resistant subjects. We examined th e role of this dyslipidemia as a risk factor of ischemic heart disease (IHD) compared with that of high LDL cholesterol (LDL-C) in the Copen hagen Male Study. In total 2910 white men, aged 53 to 74 years, free o f cardiovascular disease at baseline, were subdivided into four groups on the basis of fasting concentrations of serum TG, HDL-C, and LDL-C. ''High TG-low HDL-C'' was defined as belonging to both the highest th ird of TG and the lowest third of HDL-C: this group encompassed one fi fth of the population. ''High LDL-C'' was defined as belonging to the highest fifth of LDL-C. A control group was defined as not belonging t o either of these two groups. ''Combined dyslipidemia'' was defined as belonging to both dyslipidemic groups. Age-adjusted incidence of IHD during 8 years of follow-up was 11.4% in high TG-low HDL-C, 8.2% in hi gh LDL-C, 6.6% in the control group, and 17.5% in combined dyslipidemi a. Compared with the control group, relative risks of IHD (95% confide nce interval), adjusted for potentially confounding factors or covaria tes (age, body mass index, alcohol consumption, physical activity, non insulin-dependent diabetes, hypertension, smoking, and social class), were 1.5 (1.0-2.1), P<.05; 1.3 (0.9-2.0), P=.16; and 2.4 (1.5-4.0), P< .01. in the three dyslipidemic groups, respectively. In conclusion, th e present results showed that high TG-low HDL-C, the characteristic dy slipidemia seen in insulin-resistant subjects, was at least as powerfu l a predictor of II-ID as isolated high LDL-C. The results suggest tha t efforts to prevent IHD should include intervention against high TG-l ow HDL-C, and not just against hypercholesterolemia.