College of Public Health, Zhengzhou University, Zhengzhou, Henan, China.
BMC Geriatr. 2022 Jun 7;22(1):489. doi: 10.1186/s12877-022-03145-w.
The prevalence of obesity and diabetes is rising. The aim of this study was to determine the association of body mass index (BMI) and waist circumference (WC) with type 2 diabetes mellitus (T2DM) in the elderly and to compare the discriminatory abilities of BMI, WC and other anthropometric indicators, including waist-to-height ratio (WHtR), body adiposity estimator (BAE) and body roundness index (BRI) for T2DM.
This cross-sectional study included 69,388 subjects aged ≥ 60 years living in Xinzheng, Henan Province, from January to December 2020. The data came from the residents' electronic health records of the Xinzheng Hospital Information System. Logistic regression was used to examine the relationships. Fully adjusted models adjusted for age, sex, place of residence, alcohol consumption, smoking, physical exercise, SBP and RHR. The area under the receiver operating characteristic curve (AUC) was used to compare the discriminatory ability of different anthropometric indicators for T2DM under the influence of potential risk factors.
After adjusting for multiple covariates, compared with the first BMI quintile, the odds ratios (ORs) and 95% confidence intervals (CIs) from the second to fifth quintile for T2DM were 1.416 (1.335-1.502), 1.664 (1.570-1.764), 1.879 (1.774-1.990) and 2.156 (2.037-2.283), respectively. Compared with the first WC quintile, the ORs and 95% CIs from the second to fifth quintiles for T2DM were 1.322 (1.244-1.404), 1.549 (1.459-1.643), 1.705 (1.609-1.807) and 2.169 (2.048-2.297), respectively. Among men, compared with other anthropometric indicators (BMI, WHtR, BAE and BRI), WC showed the highest AUC (AUC: 0.629; 95% CI: 0.622-0.636). Among women, the AUCs of BMI (AUC: 0.600; 95% CI: 0.594-0.606), WC (AUC: 0.600; 95% CI: 0.593-0.606) and BAE (AUC: 0.600; 95% CI: 0.594-0.607) were similar, and the AUCs of BMI, WC and BAE were higher than WHtR, BRI.
All anthropometric indicators were positively associated with T2DM. In men, WC with the strongest positive association with T2DM was the best predictor of T2DM. In women, BMI was most strongly associated with T2DM, and the predictive powers of BMI, WC and BAE were similar. After adjusting the potential confounding factors including age, sex, place of residence, alcohol consumption, smoking, physical exercise, SBP and RHR, the effect of these factors was eliminated, the findings were independent of the covariates considered.
肥胖症和糖尿病的患病率正在上升。本研究旨在确定身体质量指数（BMI）和腰围（WC）与 2 型糖尿病（T2DM）在老年人中的关联，并比较 BMI、WC 和其他人体测量指标（包括腰高比（WHtR）、身体脂肪估算器（BAE）和身体圆润指数（BRI））对 T2DM 的判别能力。
本横断面研究纳入了 2020 年 1 月至 12 月期间居住在河南省新郑市、年龄≥60 岁的 69388 名居民。数据来自新郑医院信息系统居民电子健康记录。使用逻辑回归检验相关性。完全调整模型根据年龄、性别、居住地、饮酒、吸烟、体育锻炼、SBP 和 RHR 进行调整。受潜在危险因素影响时，使用接收者操作特征曲线（ROC）下面积（AUC）比较不同人体测量指标对 T2DM 的判别能力。
在调整了多个协变量后，与第一 BMI 五分位数相比，第二至五分位数的 T2DM 比值比（OR）和 95%置信区间（CI）分别为 1.416（1.335-1.502）、1.664（1.570-1.764）、1.879（1.774-1.990）和 2.156（2.037-2.283）。与第一 WC 五分位数相比，第二至五分位数的 T2DM 比值比（OR）和 95%CI 分别为 1.322（1.244-1.404）、1.549（1.459-1.643）、1.705（1.609-1.807）和 2.169（2.048-2.297）。在男性中，与其他人体测量指标（BMI、WHtR、BAE 和 BRI）相比，WC 显示出最高的 AUC（AUC：0.629；95%CI：0.622-0.636）。在女性中，BMI（AUC：0.600；95%CI：0.594-0.606）、WC（AUC：0.600；95%CI：0.593-0.606）和 BAE（AUC：0.600；95%CI：0.594-0.607）的 AUC 相似，且 BMI、WC 和 BAE 的 AUC 均高于 WHtR、BRI。
所有人体测量指标均与 T2DM 呈正相关。在男性中，与 T2DM 相关性最强的 WC 是 T2DM 的最佳预测指标。在女性中，BMI 与 T2DM 的相关性最强，且 BMI、WC 和 BAE 的预测能力相似。在调整了年龄、性别、居住地、饮酒、吸烟、体育锻炼、SBP 和 RHR 等潜在混杂因素后，消除了这些因素的影响，结果与考虑的协变量无关。
