Waist circumference independently associates with the risk of insulin resistance and type 2 diabetes in mexican american families.
Waist circumference independently associates with the risk of insulin resistance and type 2 diabetes in mexican american families.
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DOI：
10.1371/journal.pone.0059153
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Curran JE
中科院分区：
文献类型：
--
作者：
Mamtani M;Kulkarni H;Dyer TD;Almasy L;Mahaney MC;Duggirala R;Comuzzie AG;Blangero J;Curran JE
尽管越来越多的人认识到腰围（WC）与2型糖尿病（T2 D）和胰岛素抵抗（IR）的特定关联，但目前的指南仍然使用体重指数（BMI）作为选择工具。我们的目的是确定在以家庭为基础的环境中，WC是否是比BMI更好的T2 D预测因子。使用前瞻性收集的来自42个墨西哥裔美国大家庭的808人的数据，代表7617.92人年的随访，我们研究了WC和BMI作为T2 D累积和事件风险预测因子的表现。我们使用了稳健的统计方法，包括多基因模型，离散性状模型，赤池信息标准，比值比（OR），相对风险（RR）和Kullback-Leibler R2。使用SOLAR软件进行所有数据分析。我们发现，在多变量多基因模型中，WC是T2 D累积风险（OR = 2.76，p = 0.0002）和未来风险（RR = 2.15，p = 3.56×10−9）的独立预测因子，并且在头对头方式比较时优于BMI。 高WC（校正年龄和性别后≥94.65 cm）也与空腹血糖、胰岛素和甘油三酯水平高以及高密度脂蛋白水平低相关，表明与IR潜在相关。此外，WC与胰岛素抵抗T2 D特异性且显著相关（OR = 4.83，p = 1.01×10−13）。 我们的研究结果表明，在墨西哥裔美国人家庭中，使用WC作为T2 D未来风险的首选筛查工具的价值。此外，WC与胰岛素抵抗性T2 D特异性相关。
In spite of the growing recognition of the specific association of waist circumference (WC) with type 2 diabetes (T2D) and insulin resistance (IR), current guidelines still use body mass index (BMI) as a tool of choice. Our objective was to determine whether WC is a better T2D predictor than BMI in family-based settings. Using prospectively collected data on 808 individuals from 42 extended Mexican American families representing 7617.92 person-years follow-up, we examined the performance of WC and BMI as predictors of cumulative and incident risk of T2D. We used robust statistical methods that accounted for the kinships and included polygenic models, discrete trait modeling, Akaike information criterion, odds ratio (OR), relative risk (RR) and Kullback-Leibler R2. SOLAR software was used to conduct all the data analyses. We found that in multivariate polygenic models, WC was an independent predictor of cumulative (OR = 2.76, p = 0.0002) and future risk of T2D (RR = 2.15, p = 3.56×10−9) and outperformed BMI when compared in a head-to-head fashion. High WC (≥94.65 cm after adjusting for age and sex) was also associated with high fasting glucose, insulin and triglyceride levels and low high-density lipoprotein levels indicating a potential association with IR. Moreover, WC was specifically and significantly associated with insulin resistant T2D (OR = 4.83, p = 1.01×10−13). Our results demonstrate the value of using WC as a screening tool of choice for future risk of T2D in Mexican American families. Also, WC is specifically associated with insulin resistant T2D.
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