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在美国患有糖尿病的成年人中,内脏脂肪指数与糖尿病肾病发病率之间的关系。

Association between visceral adiposity index and incidence of diabetic kidney disease in adults with diabetes in the United States.

机构信息

Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China.

出版信息

Sci Rep. 2024 Aug 2;14(1):17957. doi: 10.1038/s41598-024-69034-x.

Abstract

Visceral adiposity index (VAI) is a reliable indicator of visceral adiposity. However, no stu-dies have evaluated the association between VAI and DKD in US adults with diabetes. Theref-ore, this study aimed to explore the relationship between them and whether VAI is a good pr-edictor of DKD in US adults with diabetes. Our cross-sectional study included 2508 participan-ts with diabetes who were eligible for the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018. Univariate and multivariate logistic regression were used to an-alyze the association between VAI level and DKD. Three models were used to control for pot-ential confounding factors, and subgroup analysis was performed for further verification. A tot-al of 2508 diabetic patients were enrolled, of whom 945 (37.68%) were diagnosed with DKD. Overall, the VAI was 3.36 ± 0.18 in the DKD group and 2.76 ± 0.11 in the control group. VAI was positively correlated with DKD (OR = 1.050, 95% CI 1.049, 1.050) after fully adjusting for co-nfounding factors. Compared with participants in the lowest tertile of VAI, participants in the highest tertile of VAI had a significantly increased risk of DKD by 35.9% (OR = 1.359, 95% CI 1.355, 1.362). Through subgroup analysis, we found that VAI was positively correlated with the occurrence of DKD in all age subgroups, male(OR = 1.043, 95% CI 1.010, 1.080), participants wit-hout cardiovascular disease(OR = 1.038, 95% CI 1.011, 1.069), hypertension (OR = 1.054, 95% CI 1.021, 1.090), unmarried participants (OR = 1.153, 95% CI 1.036, 1.294), PIR < 1.30(OR = 1.049, 95% CI 1.010, 1.094), PIR ≧ 3 (OR = 1.085, 95% CI 1.021, 1.160), BMI ≧ 30 kg/m (OR = 1.050, 95% CI 1.016, 1.091), former smokers (OR = 1.060, 95% CI 1.011, 1.117), never exercised (OR = 1.033, 95% CI 1.004, 1.067), non-Hispanic white population (OR = 1.055, 95% CI 1.010, 1.106) and non-Hipanic black population (OR = 1.129, 95% CI 1.033, 1.258). Our results suggest that elevated VAI levels are closely associated with the development of DKD in diabetic patients. VAI may be a simpl-e and cost-effective index to predict the occurrence of DKD. This needs to be verified in furt-her prospective investigations.

摘要

内脏脂肪指数(VAI)是内脏肥胖的可靠指标。然而,目前还没有研究评估美国糖尿病患者的 VAI 与 DKD 之间的关系。因此,本研究旨在探讨它们之间的关系,以及 VAI 是否是美国糖尿病患者 DKD 的良好预测指标。

我们的横断面研究纳入了 2007 年至 2018 年符合国家健康和营养检查调查(NHANES)条件的 2508 名糖尿病患者。使用单变量和多变量逻辑回归分析 VAI 水平与 DKD 之间的关联。使用三个模型控制潜在混杂因素,并进行亚组分析以进一步验证。

共纳入 2508 名糖尿病患者,其中 945 名(37.68%)被诊断为 DKD。总体而言,DKD 组的 VAI 为 3.36±0.18,对照组为 2.76±0.11。在充分调整混杂因素后,VAI 与 DKD 呈正相关(OR=1.050,95%CI 1.049,1.050)。与 VAI 最低三分位组的参与者相比,VAI 最高三分位组的参与者发生 DKD 的风险显著增加 35.9%(OR=1.359,95%CI 1.355,1.362)。通过亚组分析,我们发现 VAI 与所有年龄亚组、男性(OR=1.043,95%CI 1.010,1.080)、无心血管疾病(OR=1.038,95%CI 1.011,1.069)、高血压(OR=1.054,95%CI 1.021,1.090)、未婚(OR=1.153,95%CI 1.036,1.294)、身体质量指数(BMI)<1.30(OR=1.049,95%CI 1.010,1.094)、BMI≧30 kg/m2(OR=1.050,95%CI 1.016,1.091)、曾经吸烟者(OR=1.060,95%CI 1.011,1.117)、从不运动(OR=1.033,95%CI 1.004,1.067)、非西班牙裔白人(OR=1.055,95%CI 1.010,1.106)和非西班牙裔黑人(OR=1.129,95%CI 1.033,1.258)之间呈正相关。

我们的研究结果表明,升高的 VAI 水平与糖尿病患者 DKD 的发生密切相关。VAI 可能是预测 DKD 发生的简单且具有成本效益的指标。这需要在进一步的前瞻性研究中得到验证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e19/11297263/24cfbe99f532/41598_2024_69034_Fig1_HTML.jpg

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