Tonding Simone F, Silva Flávia M, Antonio Juliana P, Azevedo Mirela J, Canani Luis Henrique S, Almeida Jussara C
Endocrinology Division, Hospital de Clinicas de Porto Alegre, Rua Ramiro Barcelos 2350, Prédio 12, 4° andar, 90035-003 Porto Alegre, RS, Brazil.
Nutr J. 2014 Dec 23;13(1):124. doi: 10.1186/1475-2891-13-124.
This cross-sectional study aimed to evaluating the association between body adiposity markers and high-risk of coronary heart disease (CHD) in patients with type 2 diabetes.
Recent adiposity markers [waist-to-height ratio, conicity index (C-index) and body adiposity index] and traditional markers [BMI, waist circumference and waist-to-hip ratio (WHR)] were measured. The 10-year risk of fatal CHD was estimated according to UKPDS risk engine scores. Patients were divided into high (CHD risk ≥20%; n = 99) or low-moderate (CHD risk <20%; n = 321) risk groups. Multiple logistic regression models were performed to analyze associations between CHD risk (outcome) and adiposity markers.
A total of 420 patients with type 2 diabetes (61.9 ± 9.5 years; 53.5% females; HbA1c 7.6 ± 1.6%) were evaluated. The high risk group had greater proportions of elevated C-index and BMI values than patients with low-moderate risk. No between-group differences in other adiposity markers were observed. In multiple logistic regression models, only C-index values ≥1.35 were associated with CHD risk >20% (OR = 1.69; 95% CI 1.03-2.78; P = 0.039) after adjusting for confounders (sedentary lifestyle, diabetic nephropathy, serum creatinine, and diabetes duration). The association between WHR and CHD risk did not hold in this sample.
The C-index was the body adiposity marker best associated with high risk of fatal CHD in these patients with type 2 diabetes.
这项横断面研究旨在评估2型糖尿病患者身体肥胖标志物与冠心病（CHD）高危风险之间的关联。
测量近期肥胖标志物[腰高比、锥度指数（C指数）和身体肥胖指数]以及传统标志物[BMI、腰围和腰臀比（WHR）]。根据英国前瞻性糖尿病研究（UKPDS）风险引擎评分估算致命性冠心病的10年风险。患者被分为高风险组（冠心病风险≥20%；n = 99）或低 - 中度风险组（冠心病风险<20%；n = 321）。采用多元逻辑回归模型分析冠心病风险（结果）与肥胖标志物之间的关联。
共评估了420例2型糖尿病患者（61.9±9.5岁；53.5%为女性；糖化血红蛋白7.6±1.6%）。高风险组C指数和BMI值升高的比例高于低 - 中度风险患者。未观察到其他肥胖标志物的组间差异。在多元逻辑回归模型中，调整混杂因素（久坐生活方式、糖尿病肾病、血清肌酐和糖尿病病程）后，仅C指数值≥1.35与冠心病风险>20%相关（OR = 1.69；95%CI 1.03 - 2.78；P = 0.039）。在该样本中，WHR与冠心病风险之间的关联不成立。
在这些2型糖尿病患者中，C指数是与致命性冠心病高危风险最相关的身体肥胖标志物。
