Assessing different anthropometric indices and their optimal cutoffs for prediction of type 2 diabetes and impaired fasting glucose in Asians: The Jinchang Cohort Study
Assessing different anthropometric indices and their optimal cutoffs for prediction of type 2 diabetes and impaired fasting glucose in Asians: The Jinchang Cohort Study
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评估不同的人体测量指数及其预测亚洲人 2 型糖尿病和空腹血糖受损的最佳临界值：金昌队列研究
DOI：
10.1111/1753-0407.13000
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发表时间：
2019-12-02
影响因子：
4.5
通讯作者：
Bai, Yana
中科院分区：
文献类型：
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作者：
Ding, Jie;Chen, Xiaoliang;Bai, Yana
研究人体测量与糖尿病和空腹血糖受损（IFG）风险之间的关系，并比较体重指数（BMI）、腰围（WC）和腰高比（WHtR），以确定预测2型糖尿病和IFG的最佳指标及其最佳临界值。方法选取2011-2019年北京地区48 001例受试者作为研究对象。使用考克斯比例风险模型，计算BMI、WC和WHtR每1个SD变化的2型糖尿病或IFG发病风险比（HR）。比较曲线下面积（AUC）以确定预测糖尿病的最佳人体测量变量及其最佳截止值。结果在单因素和多因素校正的考克斯比例风险模型中，BMI、WC、0和WHtR与2型糖尿病或IFG风险呈正相关。在三个指标中，BMI的AUC最大，WC的AUC最小。预测糖尿病的BMI、WC和WHtR的截断值在男性中分别为24.6 kg/m2、89.5 cm和0.52，在女性中分别为23.4 kg/m2、76.5 cm和0.47。预测IFG的BMI、WC和WHtR的截断值在男性中分别为23.4 kg/m2、87.5 cm和0.50，在女性中分别为22.5 kg/m2、76.5 cm和0.47。结论：我们推导出的临界点低于最新亚洲糖尿病指南中规定的值。我们建议亚洲人BMI的临界点为23 kg/m2，男性WC的临界点为89 cm，女性为77 cm，以确定2型糖尿病的高危人群;应考虑对这些人群进行筛查。我们观察到2型糖尿病的风险与BMI、WC和WHtR之间存在显著的正相关，我们确定BMI是糖尿病的最佳肥胖预测因子。我们得出的临界点低于最新的亚洲糖尿病指南中规定的值，我们建议亚洲人的BMI临界点为23 kg/m2，男性WC临界点为89 cm，女性为77 cm，以定义2型糖尿病的高危人群;应考虑对这些人群进行筛查。
Background To study the association between anthropometric measurements and the risk of diabetes and impaired fasting glucose (IFG) and compare body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) to determine the best indicator and its optimal cutoffs for predicting type 2 diabetes and IFG. Methods A Chinese prospective (2011-2019) cohort named the Jingchang cohort that included 48 001 participants was studied. Using Cox proportional hazard models, hazard ratios (HRs) for incident type 2 diabetes or IFG per 1 SD change in BMI, WC, and WHtR were calculated. Area under the curve (AUC) was compared to identify the best anthropometric variable and its optimal cutoff for predicting diabetes. Results The association of BMI, WC,0 and WHtR with type 2 diabetes or IFG risk was positive in the univariate and multivariable-adjusted Cox proportional hazard models. Of all three indexes, the AUC of BMI was largest and that of WC was smallest. The derived cutoff values for BMI, WC, and WHtR were 24.6 kg/m(2), 89.5 cm, and 0.52 in men and 23.4 kg/m(2), 76.5 cm, and 0.47 in women for predicting diabetes, respectively. The derived cutoff values for BMI, WC, and WHtR were 23.4 kg/m(2), 87.5 cm, and 0.50 in men and 22.5 kg/m(2), 76.5 cm, and 0.47 in women for predicting IFG, respectively. Conclusions Our derived cutoff points were lower than the values specified in the most current Asian diabetes guidelines. We recommend a cutoff point for BMI in Asians of 23 kg/m(2) and for WC a cutoff point of 89 cm in men and 77 cm in women to define high-risk groups for type 2 diabetes; screening should be considered for these populations. HighlightsWe observed significant and positive associations of the risk of type 2 diabetes with BMI, WC and WHtR, and we identified BMI as the best obesity predictor for diabetes. Our derived cutoff points were lower than the values specified in the most current Asian diabetes guidelines, and we recommend a cutoff point for BMI in Asians of 23 kg/m(2) and a cutoff point for WC of 89 cm in men and 77 cm in women to define high-risk groups for type 2 diabetes; screening should be considered for these populations.