[1]万 爽),王炳源),任永成),等.腰身比、BMI、代谢异常组分及其组合与2型糖尿病关系的前瞻性巢式病例对照研究*[J].郑州大学学报(医学版),2017,(04):478-483.[doi:10.13705/j.issn.1671-6825.2017.04.026]
 WAN Shuang),WANG Bingyuan),REN Yongcheng),et al.A prospective nested case-control study on association of waist-to-height ratio, body mass index, metabolic disorders, and their combinations and type 2 diabetes mellitus[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2017,(04):478-483.[doi:10.13705/j.issn.1671-6825.2017.04.026]
点击复制

腰身比、BMI、代谢异常组分及其组合与2型糖尿病关系的前瞻性巢式病例对照研究*()
分享到:

《郑州大学学报(医学版)》[ISSN:1671-6825/CN:41-1340/R]

卷:
期数:
2017年04期
页码:
478-483
栏目:
应用研究
出版日期:
2017-07-15

文章信息/Info

Title:
A prospective nested case-control study on association of waist-to-height ratio, body mass index, metabolic disorders, and their combinations and type 2 diabetes mellitus
作者:
万 爽1)王炳源2)任永成2)王芬莉3)王 书4)罗新萍4)张 明4)胡东生4)尹 磊5)#
1)国家卫生计生委医疗管理服务指导中心 北京 100044;
2)郑州大学公共卫生学院流行病学教研室 郑州 450001;
3)空军工程大学信息与导航学院门诊部 西安 710077;
4)深圳大学医学院预防医学科 广州深圳 518060 5)河南省军区直属医院预防保健科 郑州 450003
Author(s):
WAN Shuang1) WANG Bingyuan2) REN Yongcheng2) WANG Fenli3) WANG Shu4) LUO Xinping4) ZHANG Ming4) HU Dongsheng4) YIN Lei5)
1)Center for Health Management Services to Guide, the National Health and Family Planning Commission,Beijing 100044;
2)Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001;
3)Outpatients Department, Institute of Information and Navigation, Air Force Engineering University, Xi'an 710077;
4)Department of Preventive Medicine, Medical College, Shenzhen University, Shenzhen,Guangzhou 518060;
5)Department of Prevention and Health Care, Military Region Hospital in Henan, Zhengzhou 450003
关键词:
腰身比 BMI 代谢异常 糖尿病 前瞻性巢式病例对照研究
Keywords:
waist-to-height ratio body mass index metabolic disorders diabetes mellitus prospective nested case-control study
分类号:
R181.2
DOI:
10.13705/j.issn.1671-6825.2017.04.026
摘要:
目的:探讨腰身比、BMI、代谢异常组分及其组合与2型糖尿病(T2DM)发病的关系。方法:以2007至2008年和2013至2014年建立的大样本人群队列为基础,采用巢式病例对照研究,选择河南某农村人群随访时新发T2DM患者作为病例组(722例),按照性别、年龄进行频数匹配(1GA6FA1),随机选择基线和随访时均未患T2DM的正常人群为对照组(722人)。应用Cox比例风险回归模型分析基线时腰身比、BMI、代谢异常组分及其组合与2型糖尿病发病风险的关系。结果:在调整了可能的混杂因素后,基线时腰身比肥胖、BMI异常、空腹血糖异常、高血压、甘油三酯异常均可增加T2DM的发病风险(P<0.05),高密度脂蛋白胆固醇异常不增加T2DM的发病风险(P>0.05)。在调整了多种潜在的混杂因素后,无论采用腰身比或BMI定义肥胖,与代谢正常体重正常或代谢正常腰身比正常组相比,代谢正常肥胖不增加T2DM的发病风险,代谢异常增加T2DM的发病风险(P<0.05)。结论:代谢正常肥胖不增加T2DM的发病风险,无论是否肥胖,代谢异常均可增加T2DM的发病风险。
Abstract:
Aim: To investigate the association between baseline waist-to-height ratio(WHtR), body mass index(BMI), metabolic disorders, and their combinations and the risk of incidence of type 2 diabetes mellitus(T2DM).Methods: The prospective nested case-control study design was conducted based on the previous established large cohort populations. A total of 722 cases of T2DM were identified and 722 cohort members without T2DM event at both baseline and follow-up were randomly matched by sex and age to the cases at a ratio of 1GA6FA1. Cox proportional hazards regression models were used to evaluate the risk of T2DM associated with baseline WHtR, BMI, metabolic disorders, and their combinations.Results: After adjustment for potential confounders, abnormal WHtR, abnormal BMI, abnormal fasting plasma glucose, hypertension, and abnormal triglycerides at baseline all significantly increased the risk of T2DM(P<0.05),abnormal HDL-C did not increase the risk of T2DM(P>0.05). No matter which criteria was used to define obesity, compared with metabolically healthy and normal weight or metabolically healthy and normal WHtR population, metabolically healthy obesity(MHO)did not increase the risk of T2DM(P>0.05), however, metabolically unhealthy with normal weight or obesity both increased the risk of T2DM(P<0.05).Conclusion: MHO does not increaes the risk of T2DM; whether obese or not, metabolically unhealthy might increase the risk of T2DM.

参考文献/References:

[1] FEDERATION ID. IDF diabetes atlas-7th edition 2015
[2017-02-17].http://www.diabetesatlas.org/key-messages.html.
[2] XU Y,WANG LM,HE J,et al.Prevalence and control of diabetes in Chinese adults[J].JAMA,2013,310(9):948
[3] YANG WY,LU JM,WENG JP,et al.Prevalence of diabetes among men and women in China[J].N Engl J Med,2010,362(12):1090
[4] VAZQUEZ G,DUVAL S,JACOBS DR JR,et al.Comparison of body mass index, waist circumference, and waist/hip ratio in predicting incident diabetes: a meta-analysis[J].Epidemiol Rev,2007,29:115
[5] KAHN SE,HULL RL,UTZSCHNEIDER KM.Mechanisms linking obesity to insulin resistance and type 2 diabetes[J].Nature,2006,444(7121):840
[6] PHILLIPS CM.Metabolically healthy obesity: definitions, determinants and clinical implications[J].Rev Endocr Metab Disord,2013,14(3):219
[7] DENIS GV,OBIN MS.`Metabolically healthy obesity':origins and implications[J].Mol Aspects Med,2013,34(1):59
[8] KARELIS AD,ST-PIERRE DH,CONUS F,et al.Metabolic and body composition factors in subgroups of obesity:what do we know?[J].J Clin Endocrinol Metab,2004,89(6):2569
[9] ZHANG P,WANG R,GAO C,et al.Prevalence of central obesity among adults with normal BMI and its association with metabolic diseases in Northeast China[J].PLoS One,2016,11(7):e0160402
[10]OKADA R,YASUDA Y,TSUSHITA K,et al.Upper-normal waist circumference is a risk marker for metabolic syndrome in normal-weight subjects[J].Nutr Metab Cardiovasc Dis,2016,26(1):67
[11]ASHWELL M,GUNN P,GIBSON S.Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis[J].Obes Rev,2012,13(3):275
[12]ZHANG L,WANG B,WANG C,et al.High pulse pressure is related to risk of type 2 diabetes mellitus in Chinese middle-aged females[J].Int J Cardiol,2016,220:467
[13]BAIRAKTARI E,HATZIDIMOU K,TZALLAS C,et al.Estimation of LDL cholesterol based on the Friedewald formula and on apo B levels[J].Clin Biochem,2000,33(7):549
[14]HSIEH SD,MUTO T.The superiority of waist-to-height ratio as an anthropometric index to evaluate clustering of coronary risk factors among non-obese men and women[J].Prev Med,2005,40(2):216
[15]中国肥胖问题工作组数据汇总分析协作组.我国成人体重指数和腰围对相关疾病危险因素异常的预测价值:适宜体重指数和腰围切点的研究[J].中华流行病学杂志,2002,23(1):10
[16]GRUNDY SM,CLEEMAN JI,DANIELS SR,et al.Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement[J].Circulation,2005,112(17):2735
[17]KUZUYA T,NAKAGAWA S,SATOH J,et al.Report of the Committee on the classification and diagnostic criteria of diabetes mellitus[J].Diabetes Res Clin Pract,2002,55(1):65
[18]ANDERSSON T,ALFREDSSON L,KÄLLBERG H,et al.Calculating measures of biological interaction[J].Eur J Epidemiol,2005,20(7):575
[19]WANG B,ZHUANG R,LUO X,et al.Prevalence of metabolically healthy obese and metabolically obese but normal weight in adults worldwide:a meta-analysis[J].Horm Metab Res,2015,47(11):839
[20]ZHAO Y,ZHANG M,LUO X,et al.Association of obesity categories and high blood pressure in a rural adult Chinese population[J].J Hum Hypertens,2016,30(10):613
[21]MEIGS JB,WILSON PW,FOX CS,et al.Body mass index,metabolic syndrome,and risk of type 2 diabetes or cardiovascular disease[J].J Clin Endocrinol Metab,2006,91(8):2906
[22]HINNOUHO GM,CZERNICHOW S,DUGRAVOT A,et al.Metabolically healthy obesity and the risk of cardiovascular disease and type 2 diabetes: the Whitehall Ⅱ cohort study[J].Eur Heart J,2015,36(9):551
[23]LUO D,LIU F,LI X,et al.Comparison of the effect of `metabolically healthy but obese' and `metabolically abnormal but not obese' phenotypes on development of diabetes and cardiovascular disease in Chinese[J].Endocrine,2015,49(1):130
[24]APPLETON SL,SEABORN CJ,VISVANATHAN R,et al.Diabetes and cardiovascular disease outcomes in the metabolically healthy obese phenotype: a cohort study[J].Diabetes Care,2013,36(8):2388
[25]BRADSHAW PT,MONDA KL,STEVENS J.Metabolic syndrome in healthy obese, overweight, and normal weight individuals: the Atherosclerosis Risk in Communities Study[J].Obesity(Silver Spring),2013,21(1):203
[26]CAMHI SM,WHITNEY EVANS E,HAYMAN LL,et al.Healthy eating index and metabolically healthy obesity in U.S. adolescents and adults[J].Prev Med,2015,77:23

相似文献/References:

[1]徐永太),潘静静)#,赵景志),等.河南省某地区农村居民肥胖指标与血压及高血压的关系[J].郑州大学学报(医学版),2012,(01):91.
 XU Yongtai,PAN Jingjing,ZHAO Jingzhi,et al.Relationship between obesity indices and blood pressure and hypertension among rural residents in Henan province[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2012,(04):91.

备注/Memo

备注/Memo:
*国家自然科学基金资助项目 81373074,81402752
#通信作者,男,1981年12月生,博士,主治医师,研究方向:慢性非传染性疾病的流行病学及眼科疾病的临床防治,E-mail:yinlei3008@163.com
更新日期/Last Update: 2017-07-20