Increased risk of diabetes development in subjects with the hypertriglyceridemic waist phenotype: a 4-year longitudinal study.
Increased risk of diabetes development in subjects with the hypertriglyceridemic waist phenotype: a 4-year longitudinal study.
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DOI：
10.3803/enm.2014.29.4.514
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发表时间：
2014-12-29
期刊：
影响因子：
--
通讯作者：
Rhee EJ
中科院分区：
文献类型：
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作者：
Han KJ;Lee SY;Kim NH;Chae HB;Lee TH;Jang CM;Yoo KM;Park HJ;Lee MK;Jeon WS;Park SE;Park CY;Lee WY;Oh KW;Park SW;Rhee EJ
高脂血症腰围（HTGW）表型是一个简单而廉价的筛选参数，以确定人们在心血管疾病的风险增加。我们评估了HTGW表型是否能预测韩国城市成年人的糖尿病。共招募了2，900名非糖尿病受试者（平均年龄44.3岁），包括2，078名男性（71.7%）和822名女性（28.3%），他们在2005年1月至2009年12月期间在我们中心接受了年度医学检查。受试者根据基线血清甘油三酯（TG）水平和腰围（WC）分为四组：正常WC-正常TG（NWNT）水平、正常WC-高TG水平、WC-正常TG水平升高和WC-高TG水平升高（EWHT）水平。高血清TG水平定义为≥150 mg/dL，WC增大定义为男性≥90 cm，女性≥85 cm。新的糖尿病病例是根据参与者填写的问卷和美国糖尿病协会的诊断标准确定的。采用考克斯比例风险模型分析HTGW表型与糖尿病发病率的关系。在研究期间，共诊断出101例（3.5%）新发糖尿病病例。EWHT组的糖尿病发病率（8.3%）高于NWNT组（2.2%）。基线时具有EWHT表型的受试者，校正年龄后糖尿病的校正风险比为4.113（95%置信区间[CI]，2.397 - 7.059），校正年龄、性别、总胆固醇、收缩压和饮酒史后为2.429（95% CI，1.370 - 4.307）。通过在模型中纳入基线空腹血糖水平来减弱。具有HTGW表型的受试者显示出最高的糖尿病发病风险。这个工具可能有助于识别糖尿病高危人群。
The hypertriglyceridemic waist (HTGW) phenotype is a simple and inexpensive screening parameter to identify people at increased risk of cardiovascular disease. We evaluated whether the HTGW phenotype predicts diabetes in urban Korean adults. A total of 2,900 nondiabetic subjects (mean age 44.3 years), comprising 2,078 males (71.7%) and 822 females (28.3%) who underwent annual medical check-ups at our center between January 2005 and December 2009, were recruited. The subjects were divided into four groups according to baseline serum triglyceride (TG) level and waist circumference (WC): normal WC-normal TG (NWNT) level, normal WC-high TG level, enlarged WC-normal TG level, and enlarged WC-high TG (EWHT) level. High serum TG level was defined as ≥150 mg/dL and enlarged WC was defined as ≥90 cm for men and ≥85 cm for women. New cases of diabetes were determined according to questionnaires filled in by participants and the diagnostic criteria of the American Diabetes Association. Cox proportional hazards model analysis was used to assess the association of HTGW phenotype with the incidence of diabetes. A total of 101 (3.5%) new diabetes cases were diagnosed during the study period. The EWHT group had a higher incidence of diabetes (8.3%) compared with the NWNT group (2.2%). The adjusted hazard ratio for diabetes for subjects with the EWHT phenotype at baseline was 4.113 (95% confidence interval [CI], 2.397 to 7.059) after adjustment for age, and 2.429 (95% CI, 1.370 to 4.307) after adjustment for age, sex, total cholesterol, systolic blood pressure, and alcohol drinking history. It was attenuated by inclusion of baseline fasting glucose level in the model. Subjects with the HTGW phenotype showed the highest risk of incident diabetes. This tool could be useful for identifying individuals at high risk of diabetes.