Izadi Neda, Rahimi Mer A, Shetabi Hamid R, Hashemi Nazari Seyed S, Najafi Farid
Student Research Committee, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Endocrinology, Diabetes Research Center, Department of Internal Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Int J Prev Med. 2020 Dec 11;11:188. doi: 10.4103/ijpvm.IJPVM_305_18. eCollection 2020.
The combination of dyslipidemia, obesity, and hyperglycemia can accelerate the progression to cardiovascular disease. Therefore, this study aimed to investigate dyslipidemia and its components across body mass index (BMI) levels among type II diabetic patients.
The data for this cross-sectional study were extracted from the records of diabetic patients during 2014 to 2015. About 2,300 diabetic patients had been registered, and finally, the records of 2,110 patients which were fully completed were investigated. Dyslipidemia was defined based on the NCEP/ATP III classification of lipid profile. In order to investigate about nonlinear relationship between BMI and dyslipidemia, and its components, restricted cubic spline method was used.
The median age of patients was 55 (IQR = 14) years. 61.11% was females. The median of BMI, triglyceride, cholesterol, HDL-Chol, and LDL-Chol were 28.3 kg/m, 167, 193, 41, and 110 mg/dL in patients, respectively. The prevalence of dyslipidemia was 91.29% (95% CI: 90.05-92.54). Being overweight, diabetic patients were associated with an increased risk of dyslipidemia (OR = 1.87-2.78), hypertriglyceridemia (OR = 1.64; 95% CI: 1.29-2.09), and hypo-HDL (OR = 1.55; 95% CI: 1.20-2.01). Similarly, obesity also increased the risk of dyslipidemia (OR = 1.94; 95% CI: 1.28-2.95), hypertriglyceridemia (OR = 1.66; 95% CI: 1.29-2.12), and hypo-HDL (OR = 1.86; 95% CI: 1.41-2.43). The nonlinear dose-response relationship was associated with a significant increase then decrease in the risk of dyslipidemia, hypertriglyceridemia, and hypo-HDL in men and women as per 1 kg/m increase in BMI.
With regards to the result, we know that there is no linear relationship between lipid profiles and BMI, the bell-shape association between dyslipidemia, hypertriglyceridemia, and hypo-HDL needs to be further investigated in both diabetic and general population in men and women separately. In addition, for public health section, an appropriate intervention is of most important priorities.
血脂异常、肥胖和高血糖共同作用会加速心血管疾病的进展。因此,本研究旨在调查II型糖尿病患者中不同体重指数(BMI)水平下的血脂异常情况及其构成成分。
本横断面研究的数据取自2014年至2015年糖尿病患者的记录。约2300名糖尿病患者进行了登记,最终对2110份完整填写的记录进行了调查。血脂异常根据美国国家胆固醇教育计划成人治疗组第三次报告(NCEP/ATP III)的血脂分类标准进行定义。为了研究BMI与血脂异常及其构成成分之间的非线性关系,采用了限制性立方样条法。
患者的年龄中位数为55岁(四分位间距 = 14岁)。女性占61.11%。患者的BMI、甘油三酯、胆固醇、高密度脂蛋白胆固醇(HDL-Chol)和低密度脂蛋白胆固醇(LDL-Chol)的中位数分别为28.3 kg/m²、167、193、41和110 mg/dL。血脂异常的患病率为91.29%(95%可信区间:90.05 - 92.54)。超重的糖尿病患者发生血脂异常(比值比 = 1.87 - 2.78)、高甘油三酯血症(比值比 = 1.64;95%可信区间:1.29 - 2.09)和低高密度脂蛋白血症(比值比 = 1.55;95%可信区间:1.20 - 2.01)的风险增加。同样,肥胖也增加了血脂异常(比值比 = 1.94;95%可信区间:1.28 - 2.95)、高甘油三酯血症(比值比 = 1.66;95%可信区间:1.29 - 2.12)和低高密度脂蛋白血症(比值比 = 1.86;95%可信区间:1.41 - 2.43)的风险。随着BMI每增加1 kg/m²,男性和女性的血脂异常、高甘油三酯血症和低高密度脂蛋白血症风险呈先显著增加后下降的非线性剂量反应关系。
基于研究结果,我们知道血脂水平与BMI之间不存在线性关系,血脂异常、高甘油三酯血症和低高密度脂蛋白血症之间的钟形关联需要在糖尿病患者和普通人群中分别对男性和女性进一步研究。此外,对于公共卫生领域而言,采取适当干预措施是重中之重。