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根据美国糖尿病协会标准,肥胖和血脂相关参数在识别老年前期糖尿病高危人群中的作用:2015 年健康、福利和老龄化研究分析。

Obesity- and Lipid-Related Parameters in the Identification of Older Adults with a High Risk of Prediabetes According to the American Diabetes Association: An Analysis of the 2015 Health, Well-Being, and Aging Study.

机构信息

Department of Health Sciences, Public University of Navarra, Navarrabiomed-Universidad Pública de Navarra (UPNA)-Complejo Hospitalario de Navarra (CHN), Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Navarra, Spain.

Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, 28029 Madrid, Spain.

出版信息

Nutrients. 2019 Nov 4;11(11):2654. doi: 10.3390/nu11112654.

Abstract

This study evaluated the predictive ability of 11 obesity- and lipid-related parameters, including body mass index (BMI), waist circumference (WC), waist-to-height ratio (WtHR), body roundness index (BRI), "A" body-shape index (ABSI), conicity index (CI), visceral adiposity index (VAI), triglyceride-to-glucose fasting index (TyG), triglyceride-to-glucose fasting related to BMI (TyG-BMI), triglyceride-to-glucose fasting related to WC (TyG-WC), and triglyceride-to-glucose fasting related to WtHR (TyG-WtHR), to identify patients from an elderly Colombian population with a high risk of prediabetes according to the 2016 American Diabetes Association criteria. The data were obtained from the 2015 Colombian Health and Wellbeing and Aging Survey. A total of 3307 elderly Colombian individuals (aged over 60 years) were included. Anthropometric data, fasting plasma glucose, blood lipid profiles, family history, and health-related behaviors were assessed, and prediabetes was defined as a fasting plasma glucose of 100 to 125 mg/dL. The areas under the receiver operating characteristic (ROC) curves (AUCs) were calculated for each anthropometric indicator, using the prediabetes classification to identify their sensitivity and specificity, and these indicated that the prevalence of prediabetes was 25.3% in this population. After adjusting for potential confounding factors, the TyG index was strongly associated with the odds of having prediabetes in both sexes, and multivariate logistic regression analysis showed that the ORs for prediabetes increased across quartiles ( < 0.001). The TyG index was best able to identify prediabetes in either sex (AUC and optimal cut-off = 0.700 and 8.72, and 0.695 and 8.92 for men and women, respectively), suggesting that compared to the other parameters, the TyG index has the best discriminative power to predict prediabetes in the whole population. Thus, we propose the TyG index be used as a complementary marker for assessing prediabetes in older adults.

摘要

本研究评估了 11 种肥胖和血脂相关参数的预测能力,包括体重指数(BMI)、腰围(WC)、腰高比(WtHR)、身体圆度指数(BRI)、“A”体型指数(ABSI)、锥度指数(CI)、内脏脂肪指数(VAI)、甘油三酯-葡萄糖空腹指数(TyG)、与 BMI 相关的甘油三酯-葡萄糖空腹指数(TyG-BMI)、与 WC 相关的甘油三酯-葡萄糖空腹指数(TyG-WC)和与 WtHR 相关的甘油三酯-葡萄糖空腹指数(TyG-WtHR),以根据 2016 年美国糖尿病协会标准识别出老年哥伦比亚人群中患有糖尿病前期的高危患者。数据来自 2015 年哥伦比亚健康、福利和老龄化调查。共纳入 3307 名老年哥伦比亚人(年龄超过 60 岁)。评估了人体测量数据、空腹血糖、血脂谱、家族史和与健康相关的行为,并将糖尿病前期定义为空腹血糖为 100 至 125mg/dL。使用糖尿病前期分类计算每个人体测量指标的接收者操作特征(ROC)曲线下面积(AUC),以确定其灵敏度和特异性,结果表明该人群的糖尿病前期患病率为 25.3%。在调整潜在混杂因素后,TyG 指数与两性患糖尿病前期的几率密切相关,多变量逻辑回归分析显示,糖尿病前期的 OR 随四分位值增加(<0.001)。TyG 指数在两性中均能最好地识别糖尿病前期(AUC 和最佳截断值分别为 0.700 和 8.72,男性和女性分别为 0.695 和 8.92),这表明与其他参数相比,TyG 指数在整个人群中预测糖尿病前期的判别能力最强。因此,我们建议使用 TyG 指数作为评估老年人糖尿病前期的补充标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b89/6893527/d4224fea648a/nutrients-11-02654-g001.jpg

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