Gupta Yashdeep, Goyal Alpesh, Kalaivani Mani, Tandon Nikhil
Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi 110029, Delhi, India.
Department of Biostatistics, All India Institute of Medical Sciences, New Delhi 110029, Delhi, India.
World J Cardiol. 2022 Aug 26;14(8):462-472. doi: 10.4330/wjc.v14.i8.462.
There is an unmet need to evaluate the burden of cardiometabolic risk factors in young South Asian adults, who are not preselected for glycaemia.
To evaluate young North Indian men (aged 20-50 years) for burden of cardiometabolic risk factors, in relation to parameters of homeostatic model assessment for insulin resistance (HOMA-IR) and beta-cell function (oral disposition index [oDI]).
Study participants were invited in a fasting state. Sociodemographic, anthropometric, and medical data were collected, and 75 g oral glucose tolerance test was performed with serum insulin and plasma glucose estimation at 0, 30, and 120 min. Participants were divided into quartiles for HOMA-IR and oDI (category 1: Best HOMA-IR/oDI quartile; category 3: Worst HOMA-IR/oDI quartile) and composite HOMA-IR/oDI phenotypes (phenotype 1: Best quartile for both HOMA-IR and oDI; phenotype 4: Worst quartile for both HOMA-IR and oDI) were derived.
We evaluated a total of 635 men at a mean (± SD) age of 33.9 ± 5.1 years and body mass index of 26.0 ± 3.9 kg/m. Diabetes and prediabetes were present in 34 (5.4%) and 297 (46.8%) participants, respectively. Overweight/obesity, metabolic syndrome, and hypertension were present in 388 (61.1%), 258 (40.6%), and 123 (19.4%) participants, respectively. The prevalence of dysglycaemia, metabolic syndrome, and hypertension was significantly higher in participants belonging to the worst HOMA-IR and oDI quartiles, either alone (category 3 1) or in combination (phenotype 4 1). The adjusted odds ratios for dysglycaemia (6.5 to 7.0-fold), hypertension (2.9 to 3.6-fold), and metabolic syndrome (4.0 to 12.2-fold) were significantly higher in individuals in the worst quartile of HOMA-IR and oDI (category 3), compared to those in the best quartile (category 1). The adjusted odds ratios further increased to 21.1, 5.6, and 13.7, respectively, in individuals with the worst, compared to the best composite HOMA-IR/oDI phenotypes (phenotype 4 1).
The burden of cardiometabolic risk factors is high among young Asian Indian men. Our findings highlight the importance of using parameters of insulin resistance and beta-cell function in phenotyping individuals for cardiometabolic risk.
在未预先筛选血糖情况的年轻南亚成年人中,评估心血管代谢危险因素的负担存在未满足的需求。
评估年轻的北印度男性(20 - 50岁)心血管代谢危险因素的负担,以及与胰岛素抵抗的稳态模型评估(HOMA - IR)和β细胞功能(口服处置指数[oDI])参数的关系。
邀请研究参与者处于空腹状态。收集社会人口统计学、人体测量学和医学数据,并进行75克口服葡萄糖耐量试验,在0、30和120分钟时测定血清胰岛素和血浆葡萄糖。参与者按HOMA - IR和oDI分为四分位数(类别1:最佳HOMA - IR/oDI四分位数;类别3:最差HOMA - IR/oDI四分位数),并得出综合HOMA - IR/oDI表型(表型1:HOMA - IR和oDI均为最佳四分位数;表型4:HOMA - IR和oDI均为最差四分位数)。
我们共评估了635名男性,平均(±标准差)年龄为33.9±5.1岁,体重指数为26.0±3.9kg/m²。分别有34名(5.4%)和297名(46.8%)参与者患有糖尿病和糖尿病前期。分别有388名(61.1%)、258名(40.6%)和123名(19.4%)参与者存在超重/肥胖、代谢综合征和高血压。在单独处于最差HOMA - IR和oDI四分位数(类别3对比1)或两者组合(表型4对比1)的参与者中,血糖异常、代谢综合征和高血压的患病率显著更高。与最佳四分位数(类别1)的个体相比,HOMA - IR和oDI最差四分位数(类别3)的个体中,血糖异常(6.5至7.0倍)、高血压(2.9至3.6倍)和代谢综合征(4.0至12.2倍)的调整优势比显著更高。与最佳综合HOMA - IR/oDI表型(表型4对比1)的个体相比,最差表型个体的调整优势比分别进一步增至21.1、5.6和13.7。
年轻的亚洲印度男性中心血管代谢危险因素的负担很高。我们的研究结果强调了在对个体进行心血管代谢风险表型分析时使用胰岛素抵抗和β细胞功能参数的重要性。