Evidence map›Paper›PMID 26071491›Full record

Trial reportClinical chemistry2015

Identifying an Optimal Cutpoint for the Diagnosis of Hypertriglyceridemia in the Nonfasting State.

Khendi T White, M V Moorthy, Akintunde O Akinkuolie, Olga Demler, Paul M Ridker, Nancy R Cook, Samia Mora

Open access · bronzeAbstract readClinical Trial
In one paragraph

Trial report in Clinical chemistry, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed
4.5field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 74 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Article
  4. Review
  5. Article
  6. Review
  7. Review
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Who would benefit most from postprandial lipid screening?Clinical nutrition (Edinburgh, Scotland) · 2021
    Article
  14. Article
  15. Review
  16. Nonfasting Lipids for All Patients?Clinical chemistry · 2021
    Article
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 1 institution in 2 countries.

Khendi T WhiteDivision of Preventive Medicine, Division of Internal Medicine, and.
M V MoorthyDivision of Preventive Medicine.
Akintunde O AkinkuolieDivision of Preventive Medicine.
Olga DemlerDivision of Preventive Medicine.
Paul M RidkerDivision of Preventive Medicine, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard School of Public Health, Boston, MA.
Nancy R CookDivision of Preventive Medicine, Department of Epidemiology, Harvard School of Public Health, Boston, MA.
Samia MoraDivision of Preventive Medicine, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; smora@partners.org.
General Department of Preventive Medicine · VN

Funding

Women's Health Study: Continued Follow-upR01CA047988 · NCI · BRIGHAM AND WOMEN'S HOSPITAL · PI BURING, JULIE E., LEE, I-MIN · 1991 to 2014
$28.2M
Training Program in the Epidemiology of CVDT32HL007575 · NHLBI · HARVARD UNIVERSITY (MEDICAL SCHOOL) · PI BURING, JULIE E., RIDKER, PAUL M. · 1985 to 2019
$5.0M
Women's Health Study: Continued Follow-UpR01HL080467 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI BURING, JULIE E. · 2005 to 2010
$4.5M
The Women's Health Study: Infrastructure Support for Continued Cohort Follow-upUM1CA182913 · NCI · BRIGHAM AND WOMEN'S HOSPITAL · PI BURING, JULIE E., LEE, I-MIN · 2014 to 2018
$4.0M
Total plasma and IgG glycomes, statin therapy and ASCVD eventsR01HL117861 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI MORA, SAMIA · 2013 to 2022
$3.8M
TRIAL OF VITAMIN E, BETA-CAROTENE &ASPRIN IN WOMENR01HL043851 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI BURING, JULIE E · 1991 to 2000
$1.6M
NCI NIH HHS CA 47988NCI NIH HHS R01 CA047988NCI NIH HHS UM1 CA182913NHLBI NIH HHS HL 080467NHLBI NIH HHS HL117861NHLBI NIH HHS HL43851NHLBI NIH HHS R01 HL043851NHLBI NIH HHS R01 HL080467NHLBI NIH HHS R01 HL117861NHLBI NIH HHS T32 HL007575
6 · The paper itself

Abstract

backgroundNonfasting triglycerides are similar or superior to fasting triglycerides at predicting cardiovascular events. However, diagnostic cutpoints are based on fasting triglycerides. We examined the optimal cutpoint for increased nonfasting triglycerides.

methodsWe obtained baseline nonfasting (<8 h since last meal) samples from 6391 participants in the Women's Health Study who were followed prospectively for ≤17 years. The optimal diagnostic threshold for nonfasting triglycerides, determined by logistic regression models by use of c-statistics and the Youden index (sum of sensitivity and specificity minus 1), was used to calculate hazard ratios (HRs) for incident cardiovascular events. Performance was compared to thresholds recommended by the American Heart Association (AHA) and European guidelines.

resultsThe optimal threshold was 175 mg/dL (1.98 mmol/L), with a c-statistic of 0.656, statistically better than the AHA cutpoint of 200 mg/dL (c-statistic 0.628). For nonfasting triglycerides above and below 175 mg/dL, after adjusting for age, hypertension, smoking, hormone use, and menopausal status, the HR for cardiovascular events was 1.88 (95% CI 1.52-2.33, P < 0.001), and for triglycerides measured at 0-4 and 4-8 h since the last meal, 2.05 (1.54- 2.74) and 1.68 (1.21-2.32), respectively. We validated performance of this optimal cutpoint by use of 10-fold cross-validation and bootstrapping of multivariable models that included standard risk factors plus total and HDL cholesterol, diabetes, body mass index, and C-reactive protein.

conclusionsIn this study of middle-aged and older apparently healthy women, we identified a diagnostic threshold for nonfasting hypertriglyceridemia of 175 mg/dL (1.98 mmol/L), with the potential to more accurately identify cases than the currently recommended AHA cutpoint.

Indexed as

Postprandial PeriodCardiovascular DiseasesFastingFemaleHumansHypertriglyceridemiaMiddle AgedROC CurveTriglyceridesTriglycerides

Identifiers

PMID26071491
PMCPMC4554926
OpenAlexW2109221833

What Socratic holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.