Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark.
Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.
PLoS One. 2021 Feb 25;16(2):e0247600. doi: 10.1371/journal.pone.0247600. eCollection 2021.
Abdominal obesity predict metabolic syndrome parameters at low levels of waist circumference (WC) in Africans. At the same time, the African lipid profile phenotype of low high-density lipoprotein (HDL) cholesterol without concomitant elevated triglyceride levels renders high triglyceride levels detrimental to cardiometabolic health unsuitable for identifying cardiometabolic risk in black African populations.
We aimed to identify simple clinical measures for cardiometabolic risk based on WC and HDL in an adult Kenyan population in order to determine which of the two predictors had the strongest impact.
We used linear regression analyses to assess the association between the two exposure variables WC and HDL with cardiometabolic risk factors including ultrasound-derived visceral (VAT) and subcutaneous adipose tissue (SAT) accumulation, fasting and 2-h venous glucose, fasting insulin, fasting lipid profile, and blood pressure in adult Kenyans (n = 1 370), and a sub-population with hyperglycaemia (diabetes and pre-diabetes) (n = 196). The same analyses were performed with an interaction between WC and HDL to address potential effect modification. Ultrasound-based, semi-quantitative hepatic steatosis assessment was used as a high-risk measure of cardiometabolic disease.
Mean age was 38.2 (SD 10.7) (range 17-68) years, mean body mass index was 22.3 (SD 4.5) (range 13.0-44.8) kg/m2, and 57.8% were women. Cardiometabolic risk was found in the association between both WC and HDL and all outcome variables (p<0.05) except for HDL and SAT, fasting and 2-h venous glucose. Additive cardiometabolic risk (WC and HDL interaction) was found for SAT, low-density lipoprotein cholesterol, and triglycerides. No differences in the association between WC and HDL and the outcome variables were found when comparing the full study population and the hyperglycaemia sub-population. Increase in WC and HDL were both associated with hepatic steatosis (OR 1.09, p<0.001, and OR 0.46, p = 0.031, respectively).
In adult Kenyans, increasing WC identified more cardiometabolic risk factors compared to HDL.
在非洲人群中，腹部肥胖可以预测腰围（WC）水平较低时的代谢综合征参数。与此同时，非洲人群的脂质谱特征为高密度脂蛋白（HDL）胆固醇水平低，而甘油三酯水平升高，但没有同时升高，这使得甘油三酯水平升高对心血管代谢健康有害，不适合用于识别非洲黑人人群的心血管代谢风险。
我们旨在确定基于 WC 和 HDL 的简单临床指标，以评估肯尼亚成年人群的心血管代谢风险，从而确定这两个预测因子中哪一个具有最强的影响。
我们使用线性回归分析评估了 WC 和 HDL 这两个暴露变量与心血管代谢危险因素之间的关联，包括超声检测的内脏（VAT）和皮下脂肪组织（SAT）堆积、空腹和 2 小时静脉血糖、空腹胰岛素、空腹血脂谱以及血压，纳入了肯尼亚成年人（n=1370）和高血糖（糖尿病和糖尿病前期）亚组（n=196）。还进行了 WC 和 HDL 之间的交互作用分析，以解决潜在的效应修饰问题。超声半定量肝脂肪变性评估被用作心血管代谢疾病的高危指标。
平均年龄为 38.2（SD 10.7）岁（范围 17-68 岁），平均体重指数为 22.3（SD 4.5）kg/m2（范围 13.0-44.8 kg/m2），57.8%为女性。WC 和 HDL 与所有结局变量（p<0.05）均存在相关性，除了 HDL 和 SAT、空腹和 2 小时静脉血糖外。在 SAT、低密度脂蛋白胆固醇和甘油三酯方面，发现了 WC 和 HDL 之间的附加心血管代谢风险（WC 和 HDL 交互作用）。在比较整个研究人群和高血糖亚组时，WC 和 HDL 与结局变量之间的相关性没有差异。WC 和 HDL 的增加均与肝脂肪变性相关（OR 1.09，p<0.001 和 OR 0.46，p=0.031）。
在肯尼亚成年人中，与 HDL 相比，WC 的增加与更多的心血管代谢危险因素相关。
