Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, 510515, China.
Institute of Biomedicine, Anhui Medical University, Hefei, 230032, China.
Eat Weight Disord. 2022 Mar;27(2):505-514. doi: 10.1007/s40519-021-01187-4. Epub 2021 Apr 12.
Visceral adiposity index (VAI) is a reliable indicator for the distribution and function of adipose tissue in the body. The relation of VAI with new-onset type 2 diabetes and new-onset impaired fasting glucose (IFG) remains uncertain. We aimed to investigate the prospective relation of VAI with new-onset type 2 diabetes and new-onset IFG in Chinese hypertensive adults.
A total of 14,838 hypertensive adults free of type 2 diabetes at baseline were included from the China Stroke Primary Prevention Trial. The primary outcome was new-onset type 2 diabetes, defined as physician-diagnosed diabetes or use of glucose-lowering drugs during follow-up, or fasting glucose ≥ 7.0 mmol/L at the exit visit. The secondary outcome was new-onset IFG, defined as fasting glucose < 6.1 mmol/L at baseline, while fasting glucose ≥ 6.1 mmol/L and < 7.0 mmol/L at the exit visit.
Over a median of 4.5 years' follow-up, 1612 (10.9%) participants developed type 2 diabetes. When VAI was categorized into quartiles, compared with participants in quartile 1-3 (< 2.80), significantly higher risk of new-onset type 2 diabetes (OR 1.30; 95% CI 1.08-1.56) and new-onset IFG (OR 1.28; 95% CI 1.08-1.52) was found in those in quartile 4 (≥ 2.80). Moreover, the positive associations were consistent in participants with or without single abnormal VAI components, including general obesity, abdominal obesity, elevated triglycerides and low high-density lipoprotein cholesterol (HDL-C) levels; or with different numbers of abnormal VAI components (all P interactions > 0.05).
Our study suggested a positive relation of VAI with the risk of new-onset type 2 diabetes and new-onset IFG in Chinese hypertensive patients, independent of its components.
Level III, a well-designed cohort.
内脏脂肪指数(VAI)是反映体内脂肪分布和功能的可靠指标。VAI 与新发 2 型糖尿病和新发空腹血糖受损(IFG)的关系尚不确定。我们旨在研究 VAI 与中国高血压成年人新发 2 型糖尿病和新发 IFG 的前瞻性关系。
本研究共纳入了 14838 例基线时无 2 型糖尿病的高血压成年人,他们均来自中国脑卒中一级预防试验。主要结局为新发 2 型糖尿病,定义为医生诊断的糖尿病或随访期间使用降糖药物,或在随访结束时空腹血糖≥7.0mmol/L。次要结局为新发 IFG,定义为基线时空腹血糖<6.1mmol/L,而随访结束时空腹血糖≥6.1mmol/L且<7.0mmol/L。
在中位随访 4.5 年期间,1612 名(10.9%)参与者发生了 2 型糖尿病。当 VAI 分为四等分时,与 quartile 1-3(<2.80)相比,quartile 4(≥2.80)的参与者发生新发 2 型糖尿病(OR 1.30;95%CI 1.08-1.56)和新发 IFG(OR 1.28;95%CI 1.08-1.52)的风险显著增加。此外,在具有或不具有单个异常 VAI 成分(包括一般肥胖、腹部肥胖、甘油三酯升高和低高密度脂蛋白胆固醇(HDL-C)水平)或具有不同数量异常 VAI 成分的参与者中(所有 P 交互作用均>0.05),这种阳性关联是一致的。
我们的研究表明,VAI 与中国高血压患者新发 2 型糖尿病和新发 IFG 的风险呈正相关,且与 VAI 的组成成分无关。
三级,设计良好的队列研究。