The present study tested whether in patients with
type 2 diabetes mellitus (DM) the combination of increased waist circumference and increased plasma
triglyceride (TG) levels can predict the presence of
coronary artery disease (CAD) as assessed by multidetector computed tomographic coronary angiography (CTA). In 202 patients with type 2 DM who were clinically referred for CTA, waist circumference and TG levels were measured. Patients were divided into 4 groups according to waist circumference measurements and TG levels. Increased waist circumference and TG levels (n = 61, 31%) indicated the presence of the
hypertriglyceridemic waist phenotype. Patients with low waist circumference and TG (n = 49, 24%) were considered the reference group. Physical examination and blood measurements were performed. CTA was used to determine presence and severity of CAD. In addition, plaque type was evaluated. Plasma
cholesterol levels were significantly increased in the group with increased TG levels and waist circumference, whereas
high-density lipoprotein cholesterol was significantly lower than in the reference group. There was a significant increase in the presence of any CAD (odds ratio 3.3, confidence interval 1.31 to 8.13, p <0.05) and obstructive CAD (≥50%, odds ratio 2.9, confidence interval 1.16 to 7.28, p <0.05) in the group with increased TG level and waist circumference. In addition, a significantly larger number of noncalcified and mixed plaques was observed. In conclusion, in patients with type 2 DM, presence of the
hypertriglyceridemic waist phenotype translated into a deteriorated blood
lipid profile and more extensive CAD on CTA. Accordingly, the
hypertriglyceridemic waist phenotype may serve as a practical clinical
biomarker to improve risk stratification in patients with type 2 DM.