内脏脂肪指数与中国中老年糖尿病前期人群血糖变化关联的队列研究

doi:10.12183/j.scjpm.2023.0803

摘要/Abstract

摘要： 目的通过队列研究设计探讨内脏脂肪指数（visceral adiposity index,VAI）与糖尿病前期人群血糖变化的相关性。方法基于中国健康与养老追踪调查（CHARLS）,选择纳入2011年参加基线调查和2015年参与随访的中老年糖尿病前期人群为研究对象。采用多分类logistic回归模型分析VAI与糖尿病前期人群发展为糖尿病或恢复为正常血糖的关联性。结果随访期间309例（14.29%）发展为糖尿病,1 369人（63.29%）仍然保持糖尿病前期,485人（22.42%）恢复为正常血糖。在调整了协变量后多分类logistic回归结果显示：VAI每增加1个标准差,进展为糖尿病的风险就上升6%;与Q₄（2.76~35.31）组相比,Q₁（0.03~0.93）、Q₂（0.94~1.54）、Q₃（1.55~2.75）组均会降低糖尿病发生风险,其OR及95% CI分别为（0.51,95% CI：0.35~0.74）、（0.53,95% CI：0.37~0.75）、（0.69,95% CI：0.49~0.97）;仅Q₁（0.03~0.93）组会增加恢复为正常血糖的概率（OR=1.43,95% CI：1.04~1.95）。结论 VAI与糖尿病前期进展密切相关,仅低VAI会增加恢复为正常血糖的概率。

关键词: 内脏脂肪指数, 糖尿病前期, 中老年人, 血糖, 队列研究

Abstract: Objective To investigate the association between visceral adiposity index （VAI） and blood glucose variation in the prediabetic population through a cohort study. Methods Based on the China Health and Retirement Longitudinal Study （CHARLS）, middle-aged and elderly Prediabetic people who participated in the baseline survey in 2011 and follow-up in 2015 were included. The association between VAI and the development to diabetes or the return to normoglycemia in the prediabetic population was analyzed by multiple logistic regression model. Results During follow-up, 309 （14.29%） developed to diabetes, 1 369 （63.29%） remained prediabetes, and 485 （22.42%） returned to normoglycemia. After adjusting for covariates, multiple logistic regression showed that the risk of development to diabetes increased by 6% for every standard deviation increase in VAI; compared with Q₄ （2.76-35.31） group, Q₁ （0.03-0.93）, Q₂ （0.94-1.54）, and Q₃ （1.55-2.75） groups all reduced the risk of diabetes, and the values of OR and 95% CI were （0.51, 95% CI： 0.35-0.74）, （0.53, 95% CI： 0.37-0.75）, and （0.69, 95% CI： 0.49-0.97）, respectively; only the Q₁ （0.03-0.93） group increased the probability of returning to normoglycemia （OR=1.43, 95% CI： 1.04 - 1.95）.Conclusions VAI is strongly associated with the development of prediabetes, only low VAI increases the probability of returning to normoglycemia.

Key words: Visceral adiposity index, Prediabetes, Middle-aged and elderly, Blood glucose, Cohort study

中图分类号:

R195.4

樊海龙, 牛彦斌, 郭振山, 安乾江, 王秀梅. 内脏脂肪指数与中国中老年糖尿病前期人群血糖变化关联的队列研究[J]. 华南预防医学, 2023, 49(7): 803-807.

FAN Hailong, NIU Yanbin, GUO Zhenshan, AN Qianjiang, WANG Xiumei. Association between visceral adiposity index and blood glucose variation in Chinese middle-aged and elderly prediabetic population： a cohort study[J]. South China Journal of Preventive Medicine, 2023, 49(7): 803-807.

参考文献

[1] Wang L, Gao P, Zhang M, et al.Prevalence and ethnic pattern of diabetes and prediabetes in China in 2013[J]. JAMA, 2017, 317(24): 2515-2523.
[2] Davidson KW, Barry MJ, Mangione CM, et al.Screening for prediabetes and type 2 diabetes: US preventive services task force recommendation statement[J].JAMA,2021,326(8):736-743.
[3] Shang Y, Marseglia A, Fratiglioni L, et al.Natural history of prediabetes in older adults from a population-based longitudinal study[J].J Intern Med,2019,286(3):326-340.
[4] Pan L, Xu Q, Liu J, et al.Dose-response relationship between Chinese visceral adiposity index and type 2 diabetes mellitus among middle-aged and elderly Chinese[J].Front Endocrinol (Lausanne),2022,13:959860.
[5] Lind L, Strand R, Michaëlsson K, et al.Voxel-wise study of cohort associations in whole-body MRI: Application in metabolic syndrome and its components[J].Radiology,2020, 294(3):559-567.
[6] Wan H, Wang Y, Xiang Q, et al.Associations between abdominal obesity indices and diabetic complications: Chinese visceral adiposity index and neck circumference[J].Cardiovasc Diabetol, 2020, 19(1): 118.
[7] Han M, Qin P, Li Q, et al.Chinese visceral adiposity index: A reliable indicator of visceral fat function associated with risk of type 2 diabetes[J].Diabetes Metab Res Rev,2021,37(2): e3370.
[8] Zhao Y, Hu Y, Smith JP, et al.Cohort profile: The China Health and Retirement Longitudinal Study (CHARLS)[J]. Int J Epidemiol, 2014, 43(1): 61-68.
[9] Bilous FR, Richard Donnelly FF, DM FRCP.Classification and diagnosis of diabetes[J].Diabetes Care, 2021, 44(Suppl 1): S15-S33.
[10] 中国高血压防治指南修订委员会,高血压联盟(中国),中华医学会心血管病学分会,等.中国高血压防治指南(2018年修订版)[J].中国心血管杂志,2019,24(1): 24-56.
[11] 诸骏仁,高润霖,赵水平,等.中国成人血脂异常防治指南(2016年修订版)[J].中国循环杂志,2016,31(10): 937-953.
[12] Wan H, Wang Y, Xiang Q, et al.Associations between abdominal obesity indices and diabetic complications: Chinese visceral adiposity index and neck circumference[J].Cardiovasc Diabetol, 2020,19(1):118.
[13] Qiao YS, Tang X, Chai YH, et al.Association of sarcopenia and a body shape index with overall and cause-specific mortality[J].Front Endocrinol (Lausanne),2022,13:839074.
[14] Gateva A, Assyov Y, Kamenov Z.Usefulness of different adiposity indexes for identification of metabolic disturbances in patients with obesity[J].Arch Physiol Biochem,2021:1-6.
[15] Fu W, Wang C, Zou L, et al.Association of adiposity with diabetes: A national research among Chinese adults[J]. Diabetes Metab Res Rev, 2021, 37(5): e3380.
[16] Koloverou E, Panagiotakos DB, Kyrou I, et al.Visceral adiposity index outperforms common anthropometric indices in predicting 10-year diabetes risk: Results from the ATTICA study[J]. Diabetes Metab Res Rev,2019,35(6):e3161.
[17] Gu D, Ding Y, Zhao Y, et al.Visceral adiposity index was a useful predictor of prediabetes[J]. Exp Clin Endocrinol Diabetes,2018,126(10):596-603.
[18] Liu PJ, Ma F, Lou HP, et al.Visceral adiposity index is associated with pre-diabetes and type 2 diabetes mellitus in Chinese adults aged 20-50[J].Ann Nutr Metab,2016,68(4): 235-243.
[19] Galmes-panades AM, Bennasar-veny M, Oliver P, et al. Efficacy of different modalities and frequencies of physical exercise on glucose control in people with prediabetes(GLYCEX Randomised Trial)[J].Metabolites,2022,12(12):1286.
[20] Pan L, Xu Q, Liu J, et al.Dose-response relationship between Chinese visceral adiposity index and type 2 diabetes mellitus among middle-aged and elderly Chinese[J].Front Endocrinol (Lausanne),2022,13:959860.