Daniel M, Marion S A, Sheps S B, Hertzman C, Gamble D
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Am J Clin Nutr. 1999 Mar;69(3):455-60. doi: 10.1093/ajcn/69.3.455.
It is unclear whether obesity and age modify or confound relations between abdominal adiposity and metabolic risk factors for type 2 diabetes.
Our objective was assess the consistency of relations between abdominal adiposity and glycemic variables across discrete categories of obesity and age.
We performed a stratified analysis of prevalence data from a rural screening initiative in British Columbia, Canada. Subjects were Salishan Indians, all healthy relatives of individuals with type 2 diabetes [n = 151; age: 18-80 y; body mass index (BMI, in kg/m2): 17.0-48.2]. We measured waist-to-hip ratio (WHR) (2 categories); insulin, glycated hemoglobin (Hb A1c), and 2-h glucose concentrations (2 categories); and BMI (4 categories). BMI and age-specific odds ratios (ORs) and 95% CIs were calculated.
WHR-glycemic variable relations were not consistent across BMI and age strata. Risks associated with high WHR were: for persons with BMIs from 25 to 29, elevated insulin (OR: 6.71; 95% CI: 1.41, 34.11) and Hb A1c (OR: 16.23; 95% CI: 2.04, 101.73) concentrations; for persons aged 18-34 y, elevated insulin concentrations [OR: indeterminate (+infinity); 95% CI: 1.89, +infinity]; and, for persons aged 35-49 y, elevated Hb A1c (OR: +infinity; 95% CI: 3.17, +infinity) and 2-h glucose (OR: 9.15; 95% CI: 1.74, 59.91) concentrations.
WHR discriminates risk of type 2 diabetes in overweight but not obese individuals. Abdominal adiposity is associated with elevated insulin concentrations in younger age groups and with impaired glucose control in middle-aged groups, suggesting metabolic staging by age on a continuum from insulin resistance to impaired glucose tolerance.
肥胖和年龄是否会改变或混淆腹部肥胖与2型糖尿病代谢危险因素之间的关系尚不清楚。
我们的目的是评估在不同肥胖和年龄类别中腹部肥胖与血糖变量之间关系的一致性。
我们对加拿大不列颠哥伦比亚省一项农村筛查倡议的患病率数据进行了分层分析。研究对象是萨利希印第安人，均为2型糖尿病患者的健康亲属[n = 151；年龄：18 - 80岁；体重指数（BMI，单位：kg/m²）：17.0 - 48.2]。我们测量了腰臀比（WHR）（2个类别）；胰岛素、糖化血红蛋白（Hb A1c）和2小时血糖浓度（2个类别）；以及BMI（4个类别）。计算了BMI和年龄特异性比值比（OR）及95%置信区间（CI）。
WHR与血糖变量之间的关系在BMI和年龄分层中不一致。与高WHR相关的风险为：BMI在25至29之间的人群，胰岛素浓度升高（OR：6.71；95% CI：1.41，34.11）和Hb A1c浓度升高（OR：16.23；95% CI：2.04，101.73）；18至34岁的人群，胰岛素浓度升高[OR：不确定（+∞）；95% CI：1.89，+∞]；以及35至49岁的人群，Hb A1c浓度升高（OR：+∞；95% CI：3.17，+∞）和2小时血糖浓度升高（OR：9.15；95% CI：1.74，59.91）。
WHR可区分超重但非肥胖个体患2型糖尿病的风险。腹部肥胖在较年轻年龄组与胰岛素浓度升高相关，在中年组与血糖控制受损相关，提示从胰岛素抵抗到糖耐量受损的连续过程中存在按年龄的代谢分期。
