The objective of this paper was to examine the risk of coronary heart disease (CHD) associated with metabolic dyslipidemia, defined as low HDL cholesterol concentrations and high triglyceride levels in men and women of the EPIC-Norfolk prospective study. The study population included 21,340 participants without diabetes (9,326 men and 12,014 women) who were followed for a mean of 11.4 years and during which 2,075 CHD events were recorded. Analyses revealed that metabolic dyslipidemia was a CHD risk factor in both men and women, even after adjusting for LDL cholesterol. Moreover, men with low HDL cholesterol and with high or normal triglyceride levels had about the same odds of eventually developing CHD whereas triglyceride levels were not predictive of CHD among men with normal HDL cholesterol. Analyses in women showed that the relationship between metabolic dyslipidemia and CHD risk appeared to be more dependent upon underlying risk factors such as HbA1c levels. These results suggest that metabolic dyslipidemia must be identified and managed to lower the risk of CHD.
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