Independent association between triglycerides and coronary artery disease in Taiwanese type 2 diabetic patients

Background This study evaluated the association between triglycerides (TG) and coronary artery disease (CAD) in Taiwanese adults with type 2 diabetes mellitus (T2DM). Methods A total of 1150 patients (542 men and 608 women) aged 62.5 ± 11.6 years were studied. CAD was diagnosed by history or an abnormal electrocardiogram (coronary probable or possible by Minnesota codes). Age, body mass index (BMI), smoking, use of insulin, anti-hypertensive agents and lipid-lowering agents, fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), systolic blood pressure (SBP), diastolic blood pressure (DBP), serum total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c) and low-density lipoprotein cholesterol (LDL-c) were considered as potential confounders. Results Patients with CAD were older, had higher prevalences of use of anti-hypertensive and lipid-lowering agents, and had higher BMI, SBP, DBP and TG. CAD increased significantly with increasing quartiles of TG (P-trend < 0.001). Ln(TG) was significantly correlated with BMI, FPG, HbA1c, DBP, TC, HDL-c (inversely) and LDL-c. Ln(TG) was associated with CAD with an unadjusted odds ratio of 1.411 (1.145–1.740). The odds ratio after adjustment for all confounders was slightly attenuated but still statistically significant: 1.380 (1.043–1.826). None of the other lipid parameters of TC, HDL-c and LDL-c were significantly associated with CAD in logistic models when they were entered for adjustment either separately or simultaneously. Sensitivity analyses by using history alone or history and coronary probable as diagnostic criteria for CAD did not change the association between TG and CAD. Conclusions TG is an independent risk factor for CAD in Taiwanese T2DM, independent of TC, HDL-c, LDL-c or other confounders.