墨西哥卫生工作者中肥胖与胰岛素抵抗稳态模型评估(HOMA)之间的交叉滞后关系以及肥胖在生活方式因素与HOMA之间的中介作用
Cross-Lagged Relationship Between Adiposity and HOMA and Mediating Role of Adiposity Between Lifestyle Factors and HOMA Among in Mexican Health Workers.
作者信息
Meneses-León Joacim, Quezada-Sánchez Amado D, Rojas-Russel Mario, Aparicio-Bautista Diana I, Velázquez-Cruz Rafael, Aguilar-Salinas Carlos A, Salmerón Jorge, Rivera-Paredez Berenice
机构信息
Research Center in Policies, Population and Health, School of Medicine, National Autonomous University of Mexico, Mexico City 04510, Mexico.
Center for Evaluation and Surveys Research, National Institute of Public Health, Cuernavaca 62100, Mexico.
出版信息
Nutrients. 2025 Jul 30;17(15):2497. doi: 10.3390/nu17152497.
: Unhealthy lifestyles are closely linked to insulin resistance (IR) and adiposity. However, the mediating role of adiposity in the relationship between lifestyle factors and IR is not yet fully understood. Mediation analysis may help clarify the role of adiposity in the relationship between lifestyle factors and IR. Therefore, we aimed to explore the bidirectional relationship between adiposity and IR, and to evaluate the relationship between lifestyle factors and adiposity-mediated IR in Mexican adults. : A longitudinal analysis was conducted using data from the Health Workers Cohort Study, with measurements taken every six years from 2004 to 2018. This study included 1134 participants aged from 18 to 70 years. Lifestyle factors were assessed using a self-administered questionnaire. IR was assessed using the Homeostasis Model Assessment (HOMA). Adiposity was measured through body mass index (BMI), waist circumference (WC), and body fat proportion (BFP), and BMI was used as the marker indicator to set the metric of adiposity. We fitted structural equation models with a cross-lagged specification to examine the relationships between adiposity and ln(HOMA). In our analysis, we considered baseline adiposity and ln(HOMA) as mediators of the relation between lifestyle factors and future adiposity and ln(HOMA). Models were stratified by sex and adjusted by baseline age. : Results from the cross-lagged panel model showed that, for both men and women, adiposity predicted subsequent increases in HOMA (+5.3% IC95%: 1.8%, 9.0% in men; +6.0% IC95%: 4.2%, 7.8% in women). In men, baseline adiposity acted as a mediator between lifestyle variables (physical activity, tobacco consumption, and sleep duration) and HOMA. : Our results suggest that understanding both the relationship between adiposity and HOMA and the mediating effects of adiposity is crucial for developing effective interventions to reduce IR in the Mexican population.
不健康的生活方式与胰岛素抵抗(IR)和肥胖密切相关。然而,肥胖在生活方式因素与IR之间关系中的中介作用尚未完全明确。中介分析可能有助于阐明肥胖在生活方式因素与IR关系中的作用。因此,我们旨在探讨肥胖与IR之间的双向关系,并评估墨西哥成年人中生活方式因素与肥胖介导的IR之间的关系。
使用来自卫生工作者队列研究的数据进行纵向分析,在2004年至2018年期间每六年进行一次测量。本研究纳入了1134名年龄在18至70岁之间的参与者。生活方式因素通过自我管理问卷进行评估。IR使用稳态模型评估(HOMA)进行评估。通过体重指数(BMI)、腰围(WC)和体脂比例(BFP)测量肥胖,并将BMI用作设定肥胖指标的标记指标。我们拟合了具有交叉滞后规范的结构方程模型,以检验肥胖与ln(HOMA)之间的关系。在我们的分析中,我们将基线肥胖和ln(HOMA)视为生活方式因素与未来肥胖和ln(HOMA)之间关系的中介。模型按性别分层,并根据基线年龄进行调整。
交叉滞后面板模型的结果表明,对于男性和女性,肥胖均预测了随后HOMA的增加(男性增加5.3%,IC95%:1.8%,9.0%;女性增加6.0%,IC95%:4.2%,7.8%)。在男性中,基线肥胖在生活方式变量(身体活动、烟草消费和睡眠时间)与HOMA之间起中介作用。
我们的结果表明,了解肥胖与HOMA之间的关系以及肥胖的中介作用对于制定有效的干预措施以降低墨西哥人群的IR至关重要。
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