School of Public Health, College of Public Health, Taipei Medical University, Taipei City, Taiwan.
Division of Hospitalist, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei, Taiwan.
PLoS One. 2020 Nov 4;15(11):e0241121. doi: 10.1371/journal.pone.0241121. eCollection 2020.
Central obesity is known to be associated with diabetes. Increasing lower extremity circumference was hypothesized in association with lower risk of diabetes.
This study determined which anthropometric patterns correlates the best with pre-diabetic and diabetic status among healthy adults.
Cross-sectional study with nationwide population sampling of participants was designed.
In total, 1,358 ethnic Chinese adult participants were recruited from the Nutrition and Health Survey in Taiwan 2013-2016; the whole-body composition was measured through dual-energy X-ray absorptiometry.
Fat and lean mass in whole and specific parts of body among heathy Asian adults with normal glycemic, pre-diabetic, and diabetic states were measured, separately.
The generalized linear model was used to investigate the association between body composition (lean and fat mass) and hyperglycemic status. The reduced rank regression (RRR) was used to confirm the correlation between glycemic status and predicting factors (body composition parameters).
Trunk fat positively correlated with the fasting glucose level (r = 0.327, P < 0.001) and HbA1c (r = 0.329, P < 0.001), whereas limb fat negatively correlated with the fasting glucose level (r = -0.325, P < 0.001) and HbA1c (ρ = -0.342, P < 0.001), respectively. In RRR analyses, fasting glucose and HbA1c exhibited a high positive association on fat amount per lean mass of the trunk (factor loading = 0.5319 and 0.5599, respectively) and of android area (0.6422 and 0.6104) and a high negative association fat amount per lean mass of the legs (-0.3863 and -0.3083) and gynoid area (-0.3414 and -0.3725).
For healthy community participants, increasing trunk fat had a greater risk of hyperglycemic status. Increasing lower extremity mass may confer lower risk of diabetes.
已知中心性肥胖与糖尿病有关。增加下肢周长与较低的糖尿病风险相关。
本研究旨在确定在健康成年人中，哪种人体测量模式与糖尿病前期和糖尿病状态相关性最好。
本研究采用全国性人口抽样的横断面研究设计。
共招募了 1358 名来自 2013-2016 年台湾营养与健康调查的华裔成年人参与者；通过双能 X 射线吸收法测量全身成分。
分别测量健康亚洲成年人正常血糖、糖尿病前期和糖尿病状态下全身和特定部位的体脂肪和瘦体重。
采用广义线性模型研究体成分（瘦体重和体脂肪）与高血糖状态之间的关系。采用降秩回归（RRR）确认血糖状态与预测因素（体成分参数）之间的相关性。
躯干脂肪与空腹血糖（r = 0.327，P < 0.001）和糖化血红蛋白（HbA1c）（r = 0.329，P < 0.001）呈正相关，而四肢脂肪与空腹血糖（r = -0.325，P < 0.001）和 HbA1c（ρ = -0.342，P < 0.001）呈负相关。在 RRR 分析中，空腹血糖和 HbA1c 与躯干瘦体重脂肪量（因子负荷分别为 0.5319 和 0.5599）和安卓区（0.6422 和 0.6104）呈高度正相关，与下肢瘦体重脂肪量（-0.3863 和-0.3083）和女性区（-0.3414 和-0.3725）呈高度负相关。
对于健康的社区参与者，躯干脂肪增加与高血糖状态的风险增加有关。增加下肢质量可能会降低糖尿病的风险。
