Novel metabolic indices and incident type 2 diabetes among women and men: the Rotterdam Study
Novel metabolic indices and incident type 2 diabetes among women and men: the Rotterdam Study
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DOI：
10.1007/s00125-019-4921-2
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发表时间：
2019-09-01
期刊：
影响因子：
8.2
通讯作者：
Kavousi, Maryam
中科院分区：
文献类型：
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作者：
Brahimaj, Adela;Rivadeneira, Fernando;Kavousi, Maryam
目的/假设内脏脂肪和躯干脂肪都与代谢紊乱有关。我们的目的是从鹿特丹的大规模人群研究中，调查几个新的代谢指标，结合人体测量和血脂测量，以及体脂的双能X射线吸收测量(DXA)测量，与女性和男性中发生的2型糖尿病的相关性。方法采用COX比例风险模型分析内脏肥胖指数(VAI)、脂类累积产物(LAP)、三酰甘油与葡萄糖的乘积(TYG)及其配方成分和DXA指标与2型糖尿病发病的关系。对传统糖尿病危险因素的关联性进行了调整。结果在无糖尿病的5576名女性和3988名男性中，511名女性和388名男性在平均6.5年的随访期内患上了2型糖尿病。在调整后的模型中，三个代谢指标VAI(每1SD自然对数转化的HR；95%CI)(1.49；1.36，1.65女性；1.37；1.22，1.53男性)，LAP(1.35；1.16，1.56女性；1.19；1.01，1.42男性)和TYG(1.73；1.52，1.98女性；1.43；1.26，1.62男性)，女性脂肪质量(0.63；女性的肥胖比率(1.51；1.16，1.97)与2型糖尿病的发病相关。BMI(1.45；1.28，1.65)是男性2型糖尿病的最强预测因子。结论/解释在女性中，新的联合代谢指标是比传统的人体测量和实验室测量更强的2型糖尿病危险标志，并且与DXA测量结果相当。在与男性2型糖尿病相关的研究中，联合代谢指标和DXA测量均不优于传统的人体测量和血脂测量。
Aims/hypothesis Both visceral and truncal fat have been associated with metabolic disturbances. We aimed to investigate the associations of several novel metabolic indices, combining anthropometric and lipid measures, and dual-energy x-ray absorptiometry (DXA) measurements of body fat, with incident type 2 diabetes among women and men from the large population-based Rotterdam Study. Methods Cox proportional hazards models were used to investigate associations of visceral adiposity index (VAI), lipid accumulation product (LAP), the product of triacylglycerol and glucose (TyG), their formula components and DXA measures with incident type 2 diabetes. Associations were adjusted for traditional diabetes risk factors. Results Among 5576 women and 3988 men free of diabetes, 511 women and 388 men developed type 2 diabetes during a median follow-up of 6.5 years. In adjusted models, the three metabolic indices VAI (per 1 SD naturally log-transformed HR; 95% CI) (1.49; 1.36, 1.65 in women; 1.37; 1.22, 1.53 in men), LAP (1.35; 1.16, 1.56 in women; 1.19; 1.01, 1.42 in men) and TyG (1.73; 1.52, 1.98 in women; 1.43; 1.26, 1.62 in men), gynoid fat mass (0.63; 0.45, 0.89) and android to gynoid fat ratio (1.51; 1.16, 1.97) in women were associated with incident type 2 diabetes. BMI (1.45; 1.28, 1.65) was the strongest predictor of type 2 diabetes in men. Conclusions/interpretation Among women, novel combined metabolic indices were stronger risk markers for type 2 diabetes than the traditional anthropometric and laboratory measures and were comparable with DXA measures. Neither combined metabolic indices nor DXA measures were superior to traditional anthropometric and lipid measures in association with type 2 diabetes among men.