Waist circumference trajectories and risk of type 2 diabetes mellitus in Korean population: the Korean genome and epidemiology study (KoGES)
Waist circumference trajectories and risk of type 2 diabetes mellitus in Korean population: the Korean genome and epidemiology study (KoGES)
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DOI：
10.1186/s12889-019-7077-6
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发表时间：
2019-06-13
影响因子：
4.5
通讯作者：
Jee, Sun Ha
中科院分区：
文献类型：
--
作者：
Jeon, Jooeun;Jung, Keum Ji;Jee, Sun Ha
背景：对腰围（WC）轨迹进行分类，并检查每种轨迹与2型糖尿病（T2DM）发生风险的关系。方法选取2001-2014年韩国基因组与流行病学研究（KoGES）第1 ~ 4期（2001-2008年）每两年进行一次健康检查的40岁及以上4992人。采用截尾正态模型等基于组的轨迹建模方法，确定了5个不同的轨迹组。使用Cox比例风险模型来检验轨迹与T2DM风险的关系。结果在31118人年的随访期间（平均随访时间6.2年），共发现276例T2DM病例。通过轨迹分析，在波1至波4期间发现5种不同的WC模式，即A组在极低水平下稳定，B组在低水平下稳定，C组在中等水平下稳定，D组在高水平下呈增加模式，E组在高水平上呈增加模式。随着WC扩展轨迹组，每10万人年的年龄标准化发病率增加（A组为193.9，B组为498.4，C组为661.9，D组为1845.9，E组为2045.0）。在第4波调整混杂变量后的多因素分析中，B组(风险比（HR）， 2.2；95%可信区间（CI）和1.1-4.6)、C组（HR: 2.5, 95% CI: 1.2-5.0）、D组（HR: 5.4, 95% CI: 2.7-10.9）、E组（HR: 7.3, 95% CI: 3.5-15.4）发生T2DM的风险高于a组。在进一步调整与WC强相关的体重指数后，这种相关性减弱。结论swc轨迹在高水平上是T2DM风险的重要预测因子。这一发现表明，通过评估中年T2DM高危人群的预后和预防策略，WC管理在延长寿命中的重要性。
BackgroundTo classify waist circumference (WC) trajectories and examine each trajectory's association with risk of incident type 2 diabetes mellitus (T2DM).MethodsIn Korean Genome and Epidemiology Study (KoGES 2001-2014), 4992 participants aged 40years and above who received biennial health examinations from wave 1 to wave 4 (2001-2008) were selected. Five distinct trajectory groups were identified for WC using group-based trajectory modeling methods such as censored normal model. Cox proportional hazards model was used to examine the association of trajectories with risk of T2DM.ResultsDuring 31,118 person-years of follow-up (mean follow-up duration, 6.2years), 276 incident cases of T2DM were identified. Through trajectory analysis, 5 distinct WC patterns were found during wave1 to wave 4, which were Group A was stable on very low levels, Group B was stable on low levels, Group C was stable on moderate levels, Group D had increasing pattern on elevated levels, Group E was shown increasing on high levels. Age-standardized incidences rates per 100,000 person-years were increased with WC expanding trajectory group (193.9 for Group A, 498.4 for Group B, 661.9 for Group C, 1845.9 for Group D, and 2045.0 for Group E). In multivariate analysis after adjusting for confounding variable at wave 4, Group B (Hazard ratio (HR), 2.2; 95% confidence interval (CI), and 1.1-4.6), Group C (HR: 2.5, 95% CI: 1.2-5.0), Group D (HR: 5.4, 95% CI: 2.7-10.9), Group E (HR: 7.3, 95% CI: 3.5-15.4) had a higher risk of T2DM than Group A. After further adjusting for body mass index strongly correlated with WC, the association was attenuated.ConclusionsWC trajectory was a significant predictor of T2DM risk in increasing trajectories on high level. This finding indicate the importance of WC management across prolong lifespan by assessing the prognosis and prevention strategies of high-risk populations for T2DM in middle-aged adults.