新型血脂指标与中国高血压患者 2 型糖尿病发病风险的相关性研究：广州心脏研究。
Novel lipid indicators and the risk of type 2 diabetes mellitus among Chinese hypertensive patients: findings from the Guangzhou Heart Study.
机构信息
Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Science, Guangzhou, 510080, China.
School of Public Health, Guangdong Pharmaceutical University, No. 283 Jianghai Avenue, Haizhu District, Guangzhou, 510310, China.
出版信息
Cardiovasc Diabetol. 2022 Oct 15;21(1):212. doi: 10.1186/s12933-022-01660-z.
BACKGROUND
Data are limited on whether several easily measured indices are independent predictors of type 2 diabetes mellitus (T2DM) in hypertensive patients. This study aimed to assess the association of hypertriglyceridemic-waist phenotype, triglyceride glucose (TyG) index, lipid accumulation product (LAP), and visceral adiposity index (VAI) with T2DM risk in hypertensive patients.
METHODS
This cross-sectional study included 5321 hypertensive patients from the baseline survey of the Guangzhou Heart Study. Face-to-face questionnaire survey, physical examination, and fasting blood sample collection were completed for all subjects. Odds ratio (OR) with 95% confidence interval (95% CI) were calculated by using the logistic regression model. The potential nonlinear relationship was examined using restricted cubic spline regression.
RESULTS
The prevalence of T2DM was 19.98% among hypertensive patients. After adjusting for confounders, participants with elevated triglyceride levels and enlarged waist circumference (HTGW) were associated with a 2.57-fold risk of T2DM (OR 2.57, 95% CI 2.05, 3.23). When comparing with subjects within the lowest quartile of the indices, those in the highest quartile of TyG, LAP, and VAI were associated with 5.35-fold (95% CI 4.33, 6.64), 2.65-fold (95% CI 2.11, 3.34), and 2.17-fold (95% CI 1.77, 2.67) risk of T2DM after adjusting for confounders. Every 1-unit increment of TyG, LAP, and VAI was associated with 81%, 38%, and 31% increased risk of T2DM, respectively. The nonlinear association was observed for TyG, LAP, and VAI (all P < 0.001).
CONCLUSIONS
The results found that among hypertensive patients, HTGW and a higher level of TyG, LAP, and VAI were associated with an elevated risk of T2DM. The findings suggested that HTGW, TyG, LAP, and VAI may serve as simple and effective tools for T2DM risk assessment in the prevention and management of main chronic diseases.
背景
关于多种易于测量的指标是否独立预测高血压患者 2 型糖尿病（T2DM），目前的数据有限。本研究旨在评估高三酰甘油腰围表型、甘油三酯-葡萄糖（TyG）指数、脂质蓄积产物（LAP）和内脏脂肪指数（VAI）与高血压患者 T2DM 风险的相关性。
方法
这是一项横断面研究，纳入了来自广州心脏研究基线调查的 5321 名高血压患者。对所有受试者进行面对面问卷调查、体格检查和空腹血样采集。采用 logistic 回归模型计算比值比（OR）及其 95%置信区间（95%CI）。采用限制性立方样条回归检验潜在的非线性关系。
结果
高血压患者中 T2DM 的患病率为 19.98%。调整混杂因素后，三酰甘油水平升高和腰围增大（HTGW）的患者患 T2DM 的风险增加 2.57 倍（OR 2.57，95%CI 2.05，3.23）。与 TyG、LAP 和 VAI 指数最低四分位的受试者相比，指数最高四分位的受试者患 T2DM 的风险分别增加 5.35 倍（95%CI 4.33，6.64）、2.65 倍（95%CI 2.11，3.34）和 2.17 倍（95%CI 1.77，2.67），校正混杂因素后。TyG、LAP 和 VAI 每增加 1 个单位，T2DM 的风险分别增加 81%、38%和 31%。TyG、LAP 和 VAI 均存在非线性关系（均 P < 0.001）。
结论
在高血压患者中，HTGW 以及更高水平的 TyG、LAP 和 VAI 与 T2DM 风险增加相关。这些发现表明，HTGW、TyG、LAP 和 VAI 可能是评估 T2DM 风险的简单有效的工具，可用于主要慢性病的预防和管理。
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