Hypertriglyceridemic waist check

The cut points

The 2000 study used two cut points (Lemieux 2000):

A man has the hypertriglyceridemic waist pattern when both are raised. The US-unit figures are our conversions (1 inch = 2.54 cm; triglycerides in mg/dL ÷ 88.57 = mmol/L). The calculator converts your numbers to cm and mmol/L and compares them with the cut points as printed, after rounding to 1 decimal for cm and 2 decimals for mmol/L, the way labs usually report them.

What the study found

The researchers wanted simple measures that could pick out men with what they called the atherogenic metabolic triad: high insulin, high apolipoprotein B and small, dense LDL particles. None of these three is part of a routine cholesterol test (Lemieux 2000).

• In the first study of 185 healthy men, more than 80% of the men with a waist of 90 cm or more and triglycerides of 2.0 mmol/L or more had the triad (Lemieux 2000).
• In the second study of 287 men with and without coronary artery disease, only the men with both a raised waist and raised triglycerides had higher odds of coronary artery disease than men with neither raised: an odds ratio of 3.6 (Lemieux 2000).

The authors suggested that measuring waist and fasting triglycerides together could be an inexpensive screening tool for men at high risk of coronary artery disease (Lemieux 2000). Please read this with care:

• It was a proposal from one research group, tested in two groups of men. An odds ratio compares groups. It is not your chance of having heart disease.
• Men with only one of the two raised did not have higher odds in the second study, so one raised number is not the pattern. It can still matter on its own.
• The study did not include women, so it gives no cut points for women.

How it differs from metabolic syndrome

Metabolic syndrome is diagnosed when any 3 of 5 criteria are met: a large waist, high triglycerides, low HDL cholesterol, high blood pressure and high fasting blood sugar (Alberti 2009). Its triglyceride cut point is 150 mg/dL (1.7 mmol/L), lower than the 2.0 mmol/L used here, and its waist cut point depends on sex and on the population you come from (Alberti 2009).

The hypertriglyceridemic waist looks at only two of those measures, with its own cut points, and it was proposed for men. So a man can have metabolic syndrome without this pattern, or this pattern without metabolic syndrome. To check all five criteria, use the metabolic syndrome criteria checker.

What to do next

A pattern like this cannot show whether you have heart disease. To see your estimated 10-year heart risk, use the heart risk calculator, which needs your cholesterol, blood pressure and a few other details. Read what your triglyceride level means and work out your LDL and non-HDL cholesterol from the same test.

Other research indexes also mix waist size and blood fats. The lipid accumulation product combines waist and triglycerides into one number, and the cardiometabolic index uses waist, height, triglycerides and HDL. The waist-to-hip ratio and waist-to-height ratio look at waist size alone. None of these diagnoses a disease.

Getting the right numbers

The study used fasting triglycerides (Lemieux 2000). You may be asked to fast for 9 to 12 hours before a triglyceride test (MedlinePlus). For measuring your waist, see how to measure, the WHO way on the waist-to-hip ratio page. If you check again later, measure and test the same way each time.