The objective of this paper was to determine whether the hypertriglyceridemic waist phenotype was an efficient screening tool to identify abdominally obese individuals at increased risk of coronary heart disease in a large prospective study. The study population included 21,787 participants (aged 45-79 years) of the European Prospective Investigation into Cancer and Nutrition-Norfolk study. During a mean follow-up of 9.8 years, a total of 2,109 incident cases of coronary heart disease were documented. Analyses revealed that the subgroup of individuals with a high waist circumference (≥90 cm for men; ≥85 cm for women) and elevated triglycerides (≥2.0 mmol/l for men; ≥1.5 mmol/l for women) had the most deteriorated cardiometabolic risk profile. Moreover, men with the hypertriglyceridemic waist phenotype were at increased risk of coronary heart disease with an unadjusted hazard ratio of 2.40 (95% CI: 2.02-2.87). This hazard ratio for future coronary heart disease was of 3.84 (95% CI 3.20-4.62) in women with the hypertriglyceridemic waist phenotype compared to women who did not have the phenotype. These relationships remained significant after adjustment for traditional risk factors. Thus, these results suggest that the hypertriglyceridemic waist phenotype is a marker of excess intra-abdominal (visceral) adiposity and associated metabolic abnormalities that should be included in addition to the traditionnal risk factors in the assessment for cardiovascular disease risk.
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