The hypertriglyceridemic waist phenotype among women

Background: Elevated plasma triglycerides (TG) and waist girth (hypertriglyceridemic waist (HTGW)) has been associated with elevated insulin, small dense low-density lipoprotein (sLDL) particles, and Apo B in men. The HTGW has not been reported for women and the effect of cardiorespiratory fitness (“fitness”) on associations between HTGW and coronary risk factors is unknown. Purpose: To determine the prevalence of HTGW and the influence of fitness on the relationship between HTGW and coronary risk among 137 healthy women (54±9 year; body mass index (BMI)=28±6 kg/m2). Methods: HTGW was defined as waist girth >88 cm and TG >150 mg/dl. The metabolic triad was defined as insulin >31 pmol/l, Apo B >69 mg/dl and LDL-C >84 mg/dl. Fitness was assessed with a maximal treadmill exercise test. Results: The sample prevalence of HTGW (n=15) was 11% (95% CI=5.7–16.0%). Apo B (P=0.04) and insulin (P=0.0001) increased across quintiles of waist girth, and LDL-C (P=0.004) increased across quintiles of TG. Metabolic triad prevalence was highest (67%, n=10) among HTGW women and lowest (22%, n=26) among non-HTGW women. A trend for higher coronary heart disease CHD risk factors was observed among HTGW compared with non-HTGW women. Among the HTGW group, a trend for lower CHD risk factors was observed among fit (≥6.5 METs, n=7) versus unfit women (<6.5 METs, n=8). Sample size limitations prohibited meaningful tests of significant differences in CHD risk factors when stratified simultaneously on HTGW and fitness status. Conclusions: HTGW is associated with increased coronary risk factors similarly among women as reported for men. Higher fitness may improve the CHD risk profile among women with HTGW.