Department of Non-Communicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.
Front Public Health. 2023 May 15;11:1188212. doi: 10.3389/fpubh.2023.1188212. eCollection 2023.
This study aimed to investigate the association between body mass index (BMI) and dyslipidemia and to explore the interaction between BMI and family history of dyslipidemia towards dyslipidemia in patients with type 2 diabetes.
This cross-sectional study was conducted between March and November 2018 in Zhejiang Province, China. A total of 1,756 patients with type 2 diabetes were included, physical examination data, fasting blood samples and face-to-face questionnaire survey data were collected. Restricted cubic spline analysis was used to evaluate the association between BMI and the risk of dyslipidemia. Unconditional multivariable logistic regression was used to estimate the interaction between BMI and family history of dyslipidemia towards dyslipidemia.
The prevalence of dyslipidemia was 53.7% in the study population. The risk of dyslipidemia elevated with increased BMI value ( for non-linearity <0.05). After adjusting for covariates, individuals with high BMI (≥24 kg/m) and a family history of dyslipidemia had a 4.50-fold (95% CI: 2.99-6.78) increased risk of dyslipidemia compared to the normal reference group, which was higher than the risk associated with high BMI alone (OR = 1.83, 95% CI: 1.47-2.28) or family history of dyslipidemia alone (OR = 1.79 95% CI: 1.14-2.83). Significant additive interaction between high BMI and a family history of dyslipidemia was detected, with RERI, AP, and SI values of 1.88 (95% CI: 0.17-4.10), 0.42 (95% CI: 0.02-0.62), and 2.16 (95% CI: 1.07-4.37), respectively. However, stratified by status of diabetes control, this additive interaction was only find significant among patients with controlled diabetes.
Both high BMI and a family history of dyslipidemia were related with high risk of dyslipidemia. Moreover, there were synergistic interaction between these two factors. Patients with type 2 diabetes who had a family history of dyslipidemia were more susceptible to the negative impact of being overweight or obesity on dyslipidemia.
本研究旨在探讨体重指数（BMI）与血脂异常的关系，并探讨 BMI 与血脂异常家族史之间的相互作用对 2 型糖尿病患者血脂异常的影响。
本横断面研究于 2018 年 3 月至 11 月在浙江省进行，共纳入 1756 例 2 型糖尿病患者，收集体格检查数据、空腹血样和面对面问卷调查数据。采用限制性立方样条分析评估 BMI 与血脂异常风险之间的关系。采用非条件多变量 logistic 回归估计 BMI 和血脂异常家族史对血脂异常的交互作用。
研究人群中血脂异常的患病率为 53.7%。随着 BMI 值的增加（非线性<0.05），血脂异常的风险逐渐升高。调整混杂因素后，与正常参考组相比，BMI 较高（≥24kg/m）且有血脂异常家族史的个体血脂异常的风险增加 4.50 倍（95%CI：2.99-6.78），高于 BMI 单独升高（OR=1.83，95%CI：1.47-2.28）或血脂异常家族史单独升高（OR=1.79，95%CI：1.14-2.83）的风险。高 BMI 和血脂异常家族史之间存在显著的相加交互作用，RERI、AP 和 SI 值分别为 1.88（95%CI：0.17-4.10）、0.42（95%CI：0.02-0.62）和 2.16（95%CI：1.07-4.37）。然而，按糖尿病控制状况分层，仅在控制良好的糖尿病患者中发现这种相加交互作用。
高 BMI 和血脂异常家族史均与血脂异常的高风险相关，且这两个因素之间存在协同交互作用。有血脂异常家族史的 2 型糖尿病患者更容易受到超重或肥胖对血脂异常的负面影响。
