Relation among hypertriglyceridaemia, cardiometabolic disease, and hereditary factors-design and rationale of the Stockholm hyperTRIglyceridaemia REGister study

Daniel P Andersson; Karin Littmann; Gustav Kindborg; Daniel Eklund; Kristina Sejersen; Jane Yan; Daniel Eriksson Hogling; Paolo Parini; Jonas Brinck

doi:10.1093/ehjopen/oeae010

Relation among hypertriglyceridaemia, cardiometabolic disease, and hereditary factors-design and rationale of the Stockholm hyperTRIglyceridaemia REGister study

Eur Heart J Open. 2024 Feb 20;4(2):oeae010. doi: 10.1093/ehjopen/oeae010. eCollection 2024 Mar.

Authors

Daniel P Andersson^{1

2}, Karin Littmann^{1

2}, Gustav Kindborg^{1

2}, Daniel Eklund³, Kristina Sejersen^{4

5}, Jane Yan⁶, Daniel Eriksson Hogling^{1

2}, Paolo Parini^{1

2

7}, Jonas Brinck^{1

2}

Affiliations

¹ Department of Medicine Huddinge, Karolinska Institutet, Cardio Metabolic Unit, C2:94, Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden.
² Medical Unit Endocrinology, C2:94, Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden.
³ Medical Unit Clinical Chemistry, C1-62, Karolinska University Laboratory, 141 86 Stockholm, Sweden.
⁴ Department of Medical Sciences, Section of Clinical Chemistry, Uppsala University, Uppsala University Hospital, 751 85 Uppsala, Sweden.
⁵ Unilabs AB, Unilabs Laboratory Medicine Stockholm, Section of Clinical Chemistry, 171 54 Solna, Sweden.
⁶ Institute of Environmental Medicine, Unit of Biostatistics, Karolinska Institutet, Nobels väg 13, 17 177 Stockholm, Sweden.
⁷ Department of Laboratory Medicine, Cardio Metabolic Unit, Karolinska Institutet, Alfred Nobels Allé 8, 141 52 Huddinge, Sweden.

Abstract

Aims: Hypertriglyceridaemia (hTG) is associated with atherosclerotic cardiovascular disease, pancreatitis, and non-alcoholic fatty liver disease (NAFLD) in large population-based studies. The understanding of the impact of hereditary hTG and cardiometabolic disease status on the development of hTG and its associated cardiometabolic outcomes is more limited. We aimed to establish a multigenerational cohort to enable studies of the relationship between hTG, cardiometabolic disease and hereditary factors.

Methods and results: The population-based observational Stockholm hyperTRIglyceridaemia REGister (STRIREG) study includes 1 460 184 index individuals who have measured plasma triglycerides in the clinical routine in Region Stockholm, Sweden, between 1 January 2000 and 31 December 2021. The laboratory measurements also included basic haematology, blood lipid panel, liver function tests, and HbA1c. Using the Swedish Multi-Generation register, 2 147 635 parents and siblings to the indexes were identified to form the complete study cohort. Laboratory data from participants were combined with data from several national registers that provided information on the cause of death, medical diagnoses, dispensed medicines, and socioeconomic factors including country of birth, education level, and marital status.

Conclusion: The multi-generational longitudinal STRIREG cohort provides a unique opportunity to investigate different aspects of hTG as well as heredity for other metabolic diseases. Important outcome measures include mortality, cardiovascular mortality, major cardiovascular events, development of incident diabetes, and NAFLD. The STRIREG study will provide a deeper understanding of the impact of hereditary factors and associated cardiometabolic complications.

Keywords: Cardiometabolic disease; Cardiovascular disease; Dyslipidaemia; Hypertriglyceridaemia; Pancreatitis.