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西班牙 2 型糖尿病患者高甘油三酯腰围表型的特征:一项流行病学研究。

Characterization of the hypertriglyceridemic waist phenotype in patients with type 2 diabetes mellitus in Spain: an epidemiological study.

机构信息

Departamento de Endocrinología y Nutrición, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Departamento de Medicina, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Diabetes y Enfermedades Metabólicas Asociadas CIBER (CIBERDEM), Barcelona, Spain.

Departamento de Endocrinología y Nutrición, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Departamento de Medicina, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.

出版信息

Rev Clin Esp (Barc). 2021 Dec;221(10):576-581. doi: 10.1016/j.rceng.2020.06.010. Epub 2021 Mar 6.

Abstract

BACKGROUND AND OBJECTIVES

In patients with type 2 diabetes mellitus (DM2), the presence of increased waist circumference and triglycerides is a reflection of increased visceral fat and insulin resistance. However, information about the prevalence and clinical characteristics of the hypertriglyceridemic waist (HTGW) phenotype in patients with DM2 is scarce. The aim of the present study was to analyze the prevalence and characteristics of DM2 patients with HTGW.

METHODS

We analyzed 4214 patients with DM2 in this epidemiological, cross-sectional study conducted in primary care centers across Spain between 2011 and 2012. The HTGW phenotype was defined as increased waist circumference according to the International Diabetes Federation criteria for Europids (≥ 94 cm for men and ≥ 80 cm for women) with the presence of triglyceride levels ≥ 150 mg/dL. We compared the demographic, clinical and analytical variables according to the presence or absence of the HTGW phenotype.

RESULTS

Thirty-five percent of patients presented the HTGW phenotype. Patients with the HTGW phenotype had a higher body mass index (31.14 ± 4.88 vs. 29.2 ± 4.82 kg/m2; p < .001) and glycated hemoglobin levels (7.38 ± 1.2% vs. 7 ± 1.07%; p < .001). The presence of hypertension, peripheral arterial disease, cardiac insufficiency and microvascular complications were higher when compared with patients without the HTGW phenotype. Patients with the HTGW phenotype were less adherent to prescribed diet (69.8 vs. 81%; p < .001), exercise (44.6 vs. 58.2%; p < .001) and presented greater weight increase within the year prior to the study visit (29.4 vs. 22.5%; p < .001).

CONCLUSIONS

The HTGW phenotype is prevalent in the Spanish DM2 population and identifies a subgroup of patients with higher cardiometabolic risk and prevalence of diabetic complications.

摘要

背景与目的

在 2 型糖尿病(DM2)患者中,腰围增加和甘油三酯升高反映了内脏脂肪增加和胰岛素抵抗。然而,关于 DM2 患者高甘油三酯血症性腰围(HTGW)表型的患病率和临床特征的信息有限。本研究旨在分析 DM2 患者 HTGW 的患病率和特征。

方法

我们对 2011 年至 2012 年期间在西班牙初级保健中心进行的一项流行病学、横断面研究中的 4214 名 DM2 患者进行了分析。HTGW 表型定义为根据国际糖尿病联合会(International Diabetes Federation)欧洲人标准(男性腰围≥94cm,女性腰围≥80cm)的腰围增加,且甘油三酯水平≥150mg/dL。我们根据 HTGW 表型的存在与否比较了人口统计学、临床和分析变量。

结果

35%的患者存在 HTGW 表型。与无 HTGW 表型的患者相比,HTGW 表型患者的体重指数(31.14±4.88 vs. 29.2±4.82kg/m2;p<0.001)和糖化血红蛋白水平(7.38±1.2% vs. 7±1.07%;p<0.001)更高。与无 HTGW 表型的患者相比,高血压、外周动脉疾病、心功能不全和微血管并发症的发生率更高。HTGW 表型患者对规定饮食(69.8% vs. 81%;p<0.001)、运动(44.6% vs. 58.2%;p<0.001)的依从性更低,且在研究就诊前一年体重增加更多(29.4% vs. 22.5%;p<0.001)。

结论

HTGW 表型在西班牙 DM2 人群中较为普遍,可识别出心血管代谢风险较高和糖尿病并发症患病率较高的亚组患者。

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