尚不清楚较高的甘油三酯代谢本身是否与升高的富含甘油三酯的脂蛋白和身体质量指数分离而导致死亡率的增加有关。本研究测试了以下假设：较高的甘油三酯代谢，以较高的血浆甘油和β-羟基丁酸测量，与全因死亡、心血管疾病死亡、癌症死亡和其他死亡的增加有关。本研究纳入了哥本哈根一般人群研究中的109,751名个体中的30,000名个体。在中位随访时间为10.7年的期间，有9,897名个体死亡（其中2,204名死于心血管疾病，3,366名死于癌症，2,745名死于其他原因），无一例失访。与甘油<52 µmol/L（最低四分位数）的个体相比，甘油>80 µmol/L（最高四分位数）的个体的全因死亡多重调整风险比为1.31（95%可信区间1.22-1.40）。与β-羟基丁酸<91 µmol/L（最低四分位数）的个体相比，β-羟基丁酸>154 µmol/L（最高四分位数）的个体的全因死亡多重调整风险比为1.18（1.11-1.26）。相应的高血浆甘油和β-羟基丁酸的值分别为心血管死亡为1.37（1.18-1.59）和1.18（1.03-1.35），癌症死亡为1.24（1.11-1.39）和1.16（1.05-1.29），其他死亡为1.45（1.28-1.66）和1.23（1.09-1.39）。结果不受排除随访开始几年的影响、根据血浆甘油三酯和身体质量指数进行分层调整以及进一步的调整的影响。本研究观察到随着甘油三酯代谢的增加，全因死亡、心血管病、癌症和其他死亡的风险增加。这一结果不能用较高的血浆甘油三酯和身体质量指数来解释。本文所研究的假设需要通过同位素通量研究进行进一步验证。© 作者 2023。牛津大学出版社代表欧洲心脏病学会发表。版权所有。有关权限，请发送电子邮件至：journals.permissions@oup.com。

It is unclear whether higher triglyceride metabolism per se contributes to mortality separate from elevated triglyceride-rich lipoproteins and body mass index. This study tested the hypotheses that higher triglyceride metabolism, measured as higher plasma glycerol and β-hydroxybutyrate, is associated with increased all-cause, cardiovascular, cancer, and other mortality.This study included 30 000 individuals nested within 109 751 individuals from the Copenhagen General Population Study. During a median follow-up of 10.7 years, 9897 individuals died (2204 from cardiovascular, 3366 from cancer, and 2745 from other causes), while none were lost to follow-up. In individuals with glycerol >80 µmol/L (highest fourth) vs. individuals with glycerol <52 µmol/L (lowest fourth), the multivariable adjusted hazard ratio for all-cause mortality was 1.31 (95% confidence interval 1.22-1.40). In individuals with β-hydroxybutyrate >154 µmol/L (highest fourth) vs. individuals with β-hydroxybutyrate <91 µmol/L (lowest fourth), the multivariable adjusted hazard ratio for all-cause mortality was 1.18 (1.11-1.26). Corresponding values for higher plasma glycerol and β-hydroxybutyrate were 1.37 (1.18-1.59) and 1.18 (1.03-1.35) for cardiovascular mortality, 1.24 (1.11-1.39) and 1.16 (1.05-1.29) for cancer mortality, and 1.45 (1.28-1.66) and 1.23 (1.09-1.39) for other mortality, respectively. Results were robust to exclusion of first years of follow-up, to stratification for covariates including plasma triglycerides and body mass index, and to further adjustments.This study observed an increased risk of all-cause, cardiovascular, cancer, and other mortality with higher triglyceride metabolism. This was not explained by higher plasma triglycerides and body mass index. The hypothesis studied in the present paper should be further validated by isotope flux studies.© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.