Wakabayashi Ichiro, Daimon Takashi
Department of Environmental and Preventive Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
Division of Biostatistics, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
Clin Chim Acta. 2015 Jan 1;438:274-8. doi: 10.1016/j.cca.2014.08.042. Epub 2014 Sep 6.
Patients with type 2 diabetes are prone to have obesity and dyslipidemia. The purpose of this study was to evaluate the usefulness of cardiometabolic index (CMI), a new index calculated as the product of waist-to-height ratio and triglycerides-to-HDL cholesterol ratio, for discrimination of diabetes.
Subjects were 10,196 Japanese women and men who had received annual health checkups at their workplaces. Receiver-operating characteristic (ROC) analysis and logistic regression analysis were performed to determine relationships of CMI with hyperglycemia and diabetes.
In women and men, hemoglobin A1c was significantly higher in the highest quartile of CMI than in the other lower quartiles. By using ROC analysis, the cutoff values of CMI for hyperglycemia and diabetes were determined to be 0.799 and 0.800, respectively, in women and to be 1.625 and 1.748, respectively, in men. When these cutoff values were used in logistic regression analysis, there were strong associations of CMI with hyperglycemia and diabetes in women and men (odds ratio with 95% confidence interval of subjects with vs. subjects without high CMI: 6.98 [4.68-10.42] for hyperglycemia and 14.61 [5.95-35.88] for diabetes in women; 4.42 [3.66-5.35] for hyperglycemia and 5.38 [3.89-7.44] for diabetes in men).
The results suggest that CMI is a useful new index, reflecting both adiposity and blood lipids, for discrimination of diabetes.
2型糖尿病患者容易出现肥胖和血脂异常。本研究的目的是评估心脏代谢指数(CMI)作为一种新的指数(计算方法为腰高比与甘油三酯与高密度脂蛋白胆固醇比值的乘积)在糖尿病鉴别诊断中的作用。
研究对象为10196名在工作场所接受年度健康检查的日本男女。采用受试者工作特征(ROC)分析和逻辑回归分析来确定CMI与高血糖和糖尿病之间的关系。
在女性和男性中,CMI最高四分位数组的糖化血红蛋白水平显著高于其他较低四分位数组。通过ROC分析,女性高血糖和糖尿病的CMI临界值分别确定为0.799和0.800,男性分别为1.625和1.748。在逻辑回归分析中使用这些临界值时,女性和男性的CMI与高血糖和糖尿病均有很强的相关性(高CMI组与非高CMI组受试者的比值比及95%置信区间:女性高血糖为6.98[4.68 - 10.42],糖尿病为14.61[5.95 - 35.88];男性高血糖为4.42[3.66 - 5.35],糖尿病为5.38[3.89 - 7.44])。
结果表明,CMI是一种反映肥胖和血脂的有用新指标,可用于糖尿病的鉴别诊断。