Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
J Transl Med. 2022 Nov 8;20(1):518. doi: 10.1186/s12967-022-03718-8.
Identifying patterns of variation in obesity indices and other cardiometabolic risk factors before the diagnosis of type 2 diabetes could provide insight into the critical period when drastic changes occurred and facilitate targeted interventions for the prevention of diabetes. Therefore, this study sought to explore patterns of change in obesity indices and other cardiometabolic risk factors before diabetes diagnosis.
We investigated 6305 participants (43.7% men) aged 20-65 from the Tehran Lipid and Glucose Study (TLGS) who were free of diabetes at baseline. First, we jointly estimated developmental multi-trajectories of obesity indices using multivariate latent class growth mixed model, and then patterns of cardiometabolic risk factors within the identified multi-trajectories were assessed using mixed-effects models.
Three patterns of change in obesity indices were identified. Most participants belonged to the "progressing" group (83.4%; n = 742), with a slight but steadily rising in obesity indices until diagnosis in both men and women. All multi-trajectory groups showed similar exponential increases in fasting and 2-h plasma glucose concentrations 6 years before diagnosis and linear increases in blood pressure and total and LDL cholesterol throughout follow-up. Patterns of triglyceride and HDL cholesterol accompanied each group's patterns of change in obesity indices.
Three patterns of the joint progression of obesity indices before diabetes diagnosis were accompanied by similar blood glucose patterns and other cardiometabolic risk factors. These findings suggest the impact of the increasing trend of obesity indices and other metabolic factors on the incidence of diabetes and emphasize the importance of assessing the metabolic risk factors at each visit.
在诊断 2 型糖尿病之前，识别肥胖指数和其他心血管代谢风险因素的变化模式，可以深入了解发生剧烈变化的关键时期，并为糖尿病的预防提供有针对性的干预措施。因此，本研究旨在探讨糖尿病诊断前肥胖指数和其他心血管代谢风险因素的变化模式。
我们调查了来自德黑兰血脂和血糖研究（TLGS）的 6305 名参与者（43.7%为男性），他们在基线时无糖尿病。首先，我们使用多变量潜在类别增长混合模型联合估计肥胖指数的发展多轨迹，然后使用混合效应模型评估在确定的多轨迹内的心血管代谢风险因素的模式。
确定了肥胖指数变化的三种模式。大多数参与者属于“进展”组（83.4%；n=742），男性和女性的肥胖指数都有轻微但稳定的上升，直到诊断。所有多轨迹组在诊断前 6 年的空腹和 2 小时血浆葡萄糖浓度均呈指数增长，血压以及总胆固醇和 LDL 胆固醇呈线性增长。甘油三酯和高密度脂蛋白胆固醇的模式伴随着每个组肥胖指数的变化模式。
糖尿病诊断前肥胖指数联合进展的三种模式伴随着类似的血糖模式和其他心血管代谢风险因素。这些发现表明肥胖指数和其他代谢因素的增加趋势对糖尿病的发生有影响，并强调了在每次就诊时评估代谢风险因素的重要性。
