Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, 600 Yishan Road, 200233 Shanghai, China.
Department of Information, the First Affiliated Hospital of Nanjing Medical University, Department of Medical Information, School of Biomedical Engineering and Informatics, Nanjing Medical University, Jiangsu, China.
Diabetes Res Clin Pract. 2022 Jan;183:109151. doi: 10.1016/j.diabres.2021.109151. Epub 2021 Dec 2.
AIMS: To compare the associations between four anthropometric indices including waist-to-height ratio (WHtR), waist circumference (WC), waist-hip-ratio (WHR) and body mass index (BMI) and cardio-cerebrovascular events (CCBVEs) in Chinese T2DM patients. METHODS: The associations of four anthropometric measures with CCBVEs and metabolic syndrome (MetS) were compared by multiple regression model in 3108 T2DM patients. CCBVEs was defined as a history of myocardial infarction, angina, angioplasty, coronary artery bypass surgery, transient ischemic attack, ischemic or hemorrhagic stroke. RESULTS: After controlling for age, sex and diabetes duration, the prevalence of CCBVEs and MetS significantly increased across the WHtR, WC, WHR and BMI quartiles in T2DM patients, respectively. However, when controlling for these four anthropometric measurements together, although four anthropometric measures were closely associated with MetS prevalence, only WHtR quartile was significantly associated with CCBVEs prevalence (6.5%, 13.8%, 16.9% and 21.3%, p < 0.001 for trend). After adjusting for multiple confounders including four anthropometric parameters, a regression analysis revealed that only WHtR was independently and positively associated with the presence of CCBVEs (p = 0.029). CONCLUSIONS: Compared with WC, WHR and BMI, WHtR have a stronger association with CCBVEs in T2DM subjects. WHtR maybe a better indicator than other anthropometric measurements for evaluating cardiovascular risks in T2DM.
目的:比较包括腰高比(WHtR)、腰围(WC)、腰臀比(WHR)和体重指数(BMI)在内的 4 个体型指标与中国 2 型糖尿病患者心脑血管事件(CCBVEs)的相关性。
方法:采用多元回归模型比较 3108 例 2 型糖尿病患者中 4 个体型指标与 CCBVEs 和代谢综合征(MetS)的相关性。CCBVEs 定义为心肌梗死、心绞痛、经皮冠状动脉介入治疗、冠状动脉旁路移植术、短暂性脑缺血发作、缺血性或出血性卒中等病史。
结果:在校正年龄、性别和糖尿病病程后,随着 WHtR、WC、WHR 和 BMI 四分位数的增加,2 型糖尿病患者的 CCBVEs 和 MetS 的患病率显著增加。然而,当同时控制这四个体型指标时,尽管这四个体型指标与 MetS 的患病率密切相关,但只有 WHtR 四分位数与 CCBVEs 的患病率显著相关(趋势性 p<0.001)。在校正包括四个体型参数在内的多种混杂因素后,回归分析显示,只有 WHtR 与 CCBVEs 的发生独立且呈正相关(p=0.029)。
结论:与 WC、WHR 和 BMI 相比,WHtR 与 2 型糖尿病患者的 CCBVEs 相关性更强。WHtR 可能是评估 2 型糖尿病患者心血管风险的比其他体型指标更好的指标。
Zhonghua Yu Fang Yi Xue Za Zhi. 2016-4
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