久坐行为介导了糖尿病患者体重调整后腰围指数与心血管疾病之间的关联。

Sedentary behavior mediates the association between weight-adjusted waist index and cardiovascular disease in patients with diabetes.

作者信息

Li Zhihui, Wu Min, Wang Peng, Xie Wei, Hua Yunqi, Shao Guo, Zhu Hongwei

机构信息

The Second Affiliated Hospital of Baotou Medical College, Inner Mongolia, Baotou, China.

Inner Mongolia Key Laboratory of Hypoxic Translational Medicine, Baotou Medical College, Inner Mongolia, Baotou, China.

出版信息

PLoS One. 2025 Sep 8;20(9):e0331173. doi: 10.1371/journal.pone.0331173. eCollection 2025.

DOI:10.1371/journal.pone.0331173

PMID:40920656

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12416661/

Abstract

BACKGROUND

Obesity and cardiovascular disease (CVD) are both associated with sedentary behavior. However, the role that sedentary behavior plays in the relationship between obesity and CVD in patients with diabetes remains unclear. This study aimed to examine how the weight-adjusted waist index (WWI) relates to CVD risk in patients with diabetes and to explore sedentary behavior's potential mediating role in this relationship.

METHODS

The present study analyzed data from 4,937 participants across seven NHANES cycles (2007-2020). Using logistic regression models and restricted cubic spline analyses, we evaluated the associations between WWI, sedentary behavior, and CVD in patients with diabetes. Subgroup and sensitivity analyses were conducted to confirm the stability of the results. Mediation analysis explored the mediating role of sedentary behavior in the associations between WWI and CVD.

RESULTS

The present study found that diabetic patients with CVD had higher WWI levels (11.8 ± 0.69[Formula: see text])compared to diabetic patients without CVD (11.60 ± 0.73[Formula: see text]). WWI was positively associated with CVD in patients with diabetes(OR = 1.27, 95% CI: 1.06-1.53; P < 0.01), even after accounting for potential confounders. Sedentary behavior was also positively associated with CVD(OR = 1.04, 95% CI: 1.02-1.07; P < 0.01). In a restricted cubic spline analysis, we found that WWI and sedentary time were positively correlated and approximately linearly associated with CVD risk in patients with diabetes. As WWI levels and sedentary time increased, the risk of CVD increased in patients with diabetes. Mediating analysis revealed that sedentary behaviour mediated 13.43% of the association between WWI and CVD in patients with diabetes.

CONCLUSION

We found that WWI is associated with an increased risk of CVD in patients with diabetes, and sedentary behavior partially mediates this relationship. Reducing sedentary behavior may be a key strategy to reduce obesity and CVD risk in patients with diabetes.

摘要

背景

肥胖和心血管疾病（CVD）均与久坐行为有关。然而，久坐行为在糖尿病患者肥胖与CVD关系中所起的作用仍不清楚。本研究旨在探讨体重调整腰围指数（WWI）与糖尿病患者CVD风险之间的关系，并探究久坐行为在这种关系中的潜在中介作用。

方法

本研究分析了七个国家健康与营养检查调查（NHANES）周期（2007 - 2020年）中4937名参与者的数据。使用逻辑回归模型和受限立方样条分析，我们评估了糖尿病患者中WWI、久坐行为和CVD之间的关联。进行了亚组分析和敏感性分析以确认结果的稳定性。中介分析探讨了久坐行为在WWI与CVD关联中的中介作用。

结果

本研究发现，患有CVD的糖尿病患者的WWI水平（11.8±0.69[公式：见原文]）高于未患CVD的糖尿病患者（11.60±0.73[公式：见原文]）。即使在考虑潜在混杂因素后，WWI与糖尿病患者的CVD呈正相关（OR = 1.27，95%CI：1.06 - 1.53；P < 0.01）。久坐行为也与CVD呈正相关（OR = 1.04，95%CI：1.02 - 1.07；P < 0.01）。在受限立方样条分析中，我们发现WWI和久坐时间呈正相关，并且与糖尿病患者的CVD风险大致呈线性关联。随着WWI水平和久坐时间的增加，糖尿病患者的CVD风险增加。中介分析显示，久坐行为介导了糖尿病患者中WWI与CVD之间13.43%的关联。