The adiposity indicators in relation to diabetes among adults in China: a cross-sectional study from China Health and Nutrition Survey
The adiposity indicators in relation to diabetes among adults in China: a cross-sectional study from China Health and Nutrition Survey
复制标题
中国成人肥胖指标与糖尿病的关系：来自中国健康与营养调查的横断面研究
DOI：
10.21037/apm-21-3072
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发表时间：
2022-01-07
影响因子：
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通讯作者：
Yang, Wen-Zhuo
中科院分区：
文献类型：
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作者：
Qian, Yi-Ting;Sun, Bo;Yang, Wen-Zhuo
背景：糖尿病是一种代谢性疾病，已被证实与异常或过量的体脂积累有关。我国目前尚缺乏对肥胖指标包括体重指数（BMI）、腰围（WC）、内脏脂肪指数（内脏脂肪指数）、腰高比、腰臀比（WHR）与糖尿病关系的全国性研究。方法：收集2009年中国健康与营养调查（CHNS）数据，对7,930名18岁以上的中国居民进行横断面分析。分析了身高、体重、腰围、臀围、吸烟状况、饮酒量、体力活动、能量摄入和血液样本等信息。采用二元Logistic回归模型分析2009年中国健康人群中WC、BMI、WHR、腰高比（WHtR）和内脏脂肪指数（VAI）与糖尿病患病率的关系。通过受试者工作特征曲线下面积（AUROC）验证5个肥胖指标的预测潜力。结果：研究显示，在最高四分位数的患者比在最低四分位数的患者更容易患糖尿病（OR：4.237，95% CI：3.265-5.499），BMI（OR：3.312，95%CI：2.601-4.218）、WHR（OR：3.199，95%CI：2.493-4.104）、WHtR（OR：3.760，95%CI：2.891-4.890）、VAI（OR：4.347，95%CI：3.411-5.541）。糖尿病患者WC、BMI、WHR、WHtR和VAI的受试者工作特征曲线下面积分别为0.700、0.663、0.668、0.697和0.694。结论：WC、WHtR、BMI、WHR和VAI均为中国成年人糖尿病的独立危险因素。WHtR是男性糖尿病最准确的指标，而VAI是女性糖尿病最准确的指标。
Background: Diabetes is a metabolic disease which has been confirmed to be involved with abnormal or excessive body fat accumulation. There is still a lack of nationwide research in China to discuss the relationship between adiposity indicators included body mass index (BMI), waist circumference (WC), visceral adiposity index, waist-height ratio, waist-to-hip ratio (WHR) and diabetes. The question of which one is the best indicator of obesity to predict diabetes in China remains to be unclear.Methods: Data were collected from the China Health and Nutrition Survey (CHNS) in 2009, including 7,930 participants aged over 18 years old for cross-sectional analysis. Information about height, weight, WC, hip circumference, smoking status, alcohol consumption, physical activity, energy intake and blood samples were analyzed. Binary logistic regression models were used to explore the association of WC, BMI, WHR, waist-to-height ration (WHtR) and visceral adipose index (VAI) with the prevalence of diabetes in the 2009 CHNS respectively. Predictive potential of five adiposity indicators was validated by the area under the receiver operator characteristic curve (AUROC). The optimal cut-off points were determined by Youden's index, which was used to estimate the performance of adiposity indicators.Results: The study shows patients in the highest quartile were more likely to have diabetes than those in the lowest quartile of WC (OR: 4.237, 95% CI: 3.265-5.499), BMI (OR: 3.312, 95% CI: 2.601-4.218), WHR (OR: 3.199, 95% CI: 2.493-4.104), WHtR (OR: 3.760, 95% CI: 2.891-4.890), VAI (OR: 4.347, 95% CI: 3.411-5.541). The area under the receiver operator characteristic curve of WC, BMI, WHR, WHtR and VAI for diabetes was 0.700, 0.663, 0.668, and 0.697 and 0.694, respectively. The optimal cut-offs regarding diabetes in Chinese are WHtR >= 0.520 for men and VAI >= 1.878 for women.Conclusions: Our findings indicate that WC, WHtR, BMI, WHR and VAI are all independent risk factors for diabetes among Chinese adults. WHtR is the most accurate indicator for diabetes in men, while VAI for women.