脂质蓄积产物和内脏脂肪指数与传统肥胖指数在早发2型糖尿病预测中的比较：一项横断面研究
Comparison of lipid accumulation product and visceral adiposity index with traditional obesity indices in early-onset type 2 diabetes prediction: a cross-sectional study.
作者信息
Lin Chen-Ying, Li Jing-Bo, Wu Fan, Wang Jun-Jia, An Hao-Hua, Qiu Hui-Na, Xia Long-Fei, Li Yao-Shuang, Zhai Ya-Jie, Li Chun-Jun, Lin Jing-Na
机构信息
Tianjin Union Medical Center, Tianjin Medical University, Tianjin, China.
Department of Endocrinology, Health Management Center, Tianjin Union Medical Center, Nankai University Affiliated Hospital, No. 190, Jieyuan Rd, Hongqiao District, Tianjin, 300121, China.
出版信息
Diabetol Metab Syndr. 2023 May 27;15(1):111. doi: 10.1186/s13098-023-01056-3.
BACKGROUND
The purpose of the study was to compare the efficacy of two novel obesity indices, lipid accumulation product (LAP) and visceral adiposity index (VAI), with traditional obesity indices in predicting early-onset type 2 diabetes (T2DM).
METHODS
In this cross-sectional study, a total of 744 participants, including 605 patients newly diagnosed with T2DM and 139 non-diabetic control subjects, were enrolled from a tertiary care hospital in Tianjin, China. Participants with T2DM were divided into two groups based on their age at diagnosis, namely early-onset T2DM (age less than 40 years, n = 154) and late-onset T2DM (age 40 years or older, n = 451). The predictive power of each obesity index was evaluated using receiver operating characteristic (ROC) curve analysis. Furthermore, binary logistic regression analysis was conducted to examine the independent relationship between LAP and VAI with early-onset T2DM risk. The relationship between novel obesity indices and the age of T2DM onset was also evaluated through correlation and multiple linear regression analysis.
RESULTS
In males, LAP had the highest predictive power for early-onset T2DM with an area under the ROC curve (AUC) of 0.742 (95% CI 0.684-0.799, P < 0.001). In females, VAI had the highest AUC for early-onset T2DM with a value of 0.748 (95% CI 0.657-0.839, P < 0.001), which was superior to traditional indices. Patients in the 4th quartile of LAP and VAI had 2.257 (95% CI 1.116-4.563, P = 0.023) and 4.705 (95% CI 2.132-10.384, P < 0.001) times higher risk of T2DM before age 40, compared to those in the 1st quartile, respectively. A tenfold increase in LAP was associated with a decrease in T2DM onset age of 12.862 years in males (β = -12.862, P < 0.001) and 6.507 years in females (β = -6.507, P = 0.013). A similar decrease in T2DM onset age was observed for each tenfold increase in VAI in both male (β = -15.222, P < 0.001) and female (β = -12.511, P < 0.001) participants.
CONCLUSIONS
In young Chinese individuals, LAP and VAI are recommended over traditional obesity indices for improved prediction of early-onset T2DM risk.
背景
本研究旨在比较两种新型肥胖指数，即脂质蓄积产物（LAP）和内脏脂肪指数（VAI）与传统肥胖指数在预测早发型2型糖尿病（T2DM）方面的效果。
方法
在这项横断面研究中，共纳入了744名参与者，其中包括605名新诊断的T2DM患者和139名非糖尿病对照受试者，他们来自中国天津的一家三级医院。T2DM患者根据诊断时的年龄分为两组，即早发型T2DM（年龄小于40岁，n = 154）和晚发型T2DM（年龄40岁及以上，n = 451）。使用受试者工作特征（ROC）曲线分析评估每个肥胖指数的预测能力。此外，进行二元逻辑回归分析以检验LAP和VAI与早发型T2DM风险之间的独立关系。还通过相关性和多元线性回归分析评估新型肥胖指数与T2DM发病年龄之间的关系。
结果
在男性中，LAP对早发型T2DM的预测能力最高，ROC曲线下面积（AUC）为0.742（95%CI 0.684 - 0.799，P < 0.001）。在女性中，VAI对早发型T2DM的AUC最高，为0.748（95%CI 0.657 - 0.839，P < 0.001），优于传统指数。LAP和VAI处于第4四分位数的患者在40岁之前患T2DM的风险分别是第1四分位数患者的2.257倍（95%CI 1.116 - 4.563，P = 0.023）和4.705倍（95%CI 2.132 - 10.384，P < 0.001）。LAP每增加10倍，男性T2DM发病年龄降低12.862岁（β = -12.862，P < 0.001），女性降低6.507岁（β = -6.507，P = 0.013）。在男性（β = -15.222，P < 0.001）和女性（β = -12.511，P < 0.001）参与者中，VAI每增加10倍，T2DM发病年龄也有类似程度的降低。
结论
在中国年轻人中，推荐使用LAP和VAI而非传统肥胖指数来更好地预测早发型T2DM风险。
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