中国东部正常血压人群中脂质积聚产物与糖尿病家族史对空腹血糖受损及糖尿病风险的交互作用分析：一项基于社区的横断面调查
Interaction analysis of lipid accumulation product and family history of diabetes on impaired fasting glucose and diabetes risk in population with normotension in Eastern China: a community-based cross-sectional survey.
作者信息
Shu Li, Zhao Yingying, Shen Yanqi, Jia Linlin, Zhang Jiaye
机构信息
School of Public Health, Bengbu Medical College, Bengbu, Anhui Province, China.
Bengbu Health Board, Bengbu, Anhui Province, China.
出版信息
Arch Public Health. 2022 Oct 1;80(1):217. doi: 10.1186/s13690-022-00972-6.
BACKGROUND
Lipid accumulation product (LAP) is considered to be a new convenient useful indicator to assess the visceral fat. Therefore, we aimed to evaluate the risk factors of impaired fasting glucose (IFG) and diabetes, and explore the possible interacting influences of LAP with other factors on the risk of IFG and diabetes among Chinese normotension adults.
METHODS
A multistage stratified cluster sampling method was conducted to select urban residents in Bengbu, China. For each eligible participant, data on questionnaire survey, anthropometric measurements and laboratory tests were obtained. The effects of body mass index (BMI), waist circumference (WC), waist to height ratio (WHtR) and LAP for predicting IFG and diabetes were performed by multiple logistic regressions and receiver operating characteristic (ROC) analyses. The interaction effects were evaluated by relative excess risk of interaction (RERI), attributable proportion due to interaction (AP) and synergy index (SI).
RESULTS
Six thousand, four hundred sixty-seven normotension subjects (2695 men and 3772 women) were enrolled in our study, the prevalence of IFG and diabetes were 9.37% and 14.33%, respectively. When assessed using ROC curve analysis, LAP exhibited higher diagnostic accuracy for identifying IFG and diabetes than BMI, the area under the AUC curve was 0.650 (95% CI: 0.637 to 0.662). After adjustment for age, sex, educational level and other confounding factors, multivariate logistic regression analyses indicated that subjects with the fourth quartile of LAP were more likely to develop IFG (adjusted OR: 2.735, 95% CI: 1.794-4.170) and diabetes (adjusted OR: 1.815, 95% CI: 1.297-2.541) than those with the first quartile. A significant interaction between LAP and family history of diabetes was observed in participants (RERI = 1.538, 95%CI: 0.167 to 3.612; AP = 0.375, 95%CI: 0.118 to 0.631; SI = 1.980, 95%CI: 1.206 to 3.251). However, a significant interaction between LAP and abdominal obesity was indicated by the value of RERI (1.492, 95%CI: 0.087 to 3.723) and AP (0.413, 95%CI: 0.014 to 0.756), but not the value of SI (1.824, 95%CI: 0.873 to 3.526).
CONCLUSION
Our results demonstrated that there might be synergistic effect between LAP and family history of diabetes on the risk of IFG and diabetes.
背景
脂质蓄积产物（LAP）被认为是评估内脏脂肪的一种新的便捷有用指标。因此，我们旨在评估空腹血糖受损（IFG）和糖尿病的危险因素，并探讨在中国正常血压成年人中LAP与其他因素对IFG和糖尿病风险可能的交互影响。
方法
采用多阶段分层整群抽样方法在中国蚌埠市选取城市居民。对每位符合条件的参与者，获取问卷调查、人体测量和实验室检测数据。通过多元逻辑回归和受试者工作特征（ROC）分析评估体重指数（BMI）、腰围（WC）、腰高比（WHtR）和LAP对预测IFG和糖尿病的作用。通过交互作用的相对超额危险度（RERI）、交互作用归因比例（AP）和协同指数（SI）评估交互效应。
结果
本研究纳入了6467名正常血压受试者（2695名男性和3772名女性），IFG和糖尿病的患病率分别为9.37%和14.33%。当使用ROC曲线分析进行评估时，LAP在识别IFG和糖尿病方面表现出比BMI更高的诊断准确性，AUC曲线下面积为0.650（95%CI：0.637至0.662）。在调整年龄、性别、教育水平和其他混杂因素后，多元逻辑回归分析表明，LAP处于第四四分位数的受试者比处于第一四分位数的受试者更易发生IFG（调整后的OR：2.735，95%CI：1.794 - 4.170）和糖尿病（调整后的OR：1.815，95%CI：1.297 - 2.541）。在参与者中观察到LAP与糖尿病家族史之间存在显著交互作用（RERI = 1.538，95%CI：0.167至3.612；AP = 0.375，95%CI：0.118至0.631；SI = 1.980，95%CI：1.206至3.251）。然而，RERI值（1.
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