Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan.
Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
Int J Environ Res Public Health. 2021 Mar 17;18(6):3096. doi: 10.3390/ijerph18063096.
Fasting plasma glucose (FPG) and obesity-related indices are prognostic factors for adverse outcomes in both subjects with and without diabetes. A few studies have investigated sex differences in obesity indices related to the risk of diabetes, however no studies have compared the relationship between FPG and obesity-related indices by diabetes and sex. Therefore, in this study, we compared the curve shapes of FPG and various obesity-related indices by diabetes, and further explored sex differences in these associations. Data were derived from the Taiwan Biobank database, which included 5000 registered individuals. We used an adjusted generalized linear regression model and calculated the difference of least square means (Lsmean; standard error, SE) for males and females with and without diabetes. Associations between obesity-related indices and fasting glucose level by diabetes and sex groups were estimated, and the ORTHOREG procedure was used to construct B-splines. The post-fitting for linear models procedure was used to determine the range at which the trends separated significantly. The diabetes/sex/FPG interaction term was significant for all obesity-related indices, including body mass index, waist circumference, hip circumference, waist-to-hip ratio, waist-to-height ratio, lipid accumulation product, body roundness index, conicity index, body adiposity index and abdominal volume index. B-spline comparisons between males and females did not reach significance. However, FPG affected the trend towards obesity-related indices. As the fasting glucose level increased, the values of obesity-related indices varied more obviously in the participants without diabetes than in those with diabetes mellitus. The current study revealed that there was a different relationship between FPG and obesity-related indices by diabetes and sex. FPG affected the trend towards obesity-related indices more obviously in participants without diabetes than in those with diabetes. Further studies with a longitudinal design would provide a better understanding of the underlying mechanisms for the relationships.
空腹血糖（FPG）和与肥胖相关的指标是糖尿病患者和非糖尿病患者不良结局的预后因素。一些研究调查了与糖尿病风险相关的肥胖指标的性别差异，但尚无研究比较糖尿病和性别对 FPG 和与肥胖相关指标之间关系的影响。因此，在这项研究中，我们比较了糖尿病患者和非糖尿病患者的 FPG 和各种肥胖相关指标的曲线形状，并进一步探讨了这些关联的性别差异。数据来自台湾生物库数据库，其中包括 5000 名注册个体。我们使用调整后的广义线性回归模型，并计算了糖尿病患者和非糖尿病患者中男性和女性的最小二乘均值（Lsmean；标准误差，SE）的差异。估计了肥胖相关指标与空腹血糖水平之间的关联，并使用 ORTHOREG 程序构建 B 样条。对于所有肥胖相关指标，包括体重指数、腰围、臀围、腰臀比、腰高比、脂质蓄积产物、身体圆润指数、锥形指数、身体脂肪指数和腹部容量指数，糖尿病/性别/FPG 交互项均有统计学意义。B 样条比较在男性和女性之间没有达到统计学意义。然而，FPG 影响了肥胖相关指标的趋势。随着空腹血糖水平的升高，无糖尿病患者的肥胖相关指标值的变化比糖尿病患者更为明显。本研究表明，FPG 与肥胖相关指标之间的关系在糖尿病和性别方面存在差异。在无糖尿病患者中，FPG 对肥胖相关指标趋势的影响比糖尿病患者更为明显。进一步的纵向设计研究将提供对这些关系潜在机制的更好理解。
