Association of Adiposity With Incident Diabetes Among Black Adults in the Jackson Heart Study.
Association of Adiposity With Incident Diabetes Among Black Adults in the Jackson Heart Study.
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DOI：
10.1161/jaha.120.020716
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发表时间：
2021-09-21
影响因子：
5.4
通讯作者：
Golden SH
中科院分区：
文献类型：
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作者：
Joseph JJ;Kluwe B;Echouffo-Tcheugui JB;Zhao S;Brock G;Kline D;Odei JB;Kalyani RR;Bradley DP;Hsueh WA;Sims M;Golden SH
人体测量、脂肪因子和计算机断层扫描测量肥胖对预测黑人糖尿病的预后价值，特别是通过血糖正常与糖尿病前期的比较，仍然不完全清楚。在JHS（杰克逊心脏研究）中无糖尿病的黑人受试者中，腰围[WC]、体重指数、脂联素、瘦素和瘦素：脂联素比率在样本1（基线[2000-2004]的2422名受试者）中标准化，在检查2（2005-2008）的1537名受试者中标准化WC、体重指数、内脏脂肪组织（VAT）、皮下脂肪组织和肝脏衰减（样本2）。使用调整传统风险因素的区间删失考克斯模型估计糖尿病的风险比（HR），并使用C指数进行验证。在5年中，样本1和样本2分别发生了300例和122例糖尿病事件。在样本1和样本2中，log-瘦素：脂联素比值和VAT高1-SD与糖尿病的相关性最强（HR，1.95 [95%CI，1.67-2.27]和1.76 [95%CI，1.52-2.04]），判别力（C指数0.68 [95%CI，0.64-0.71]和C指数0.67 [95%CI，0.61-0.74]）。血糖正常组与糖尿病前期组相比，WC、肝脏衰减和增值税与糖尿病的相关性高出1.3至1.9倍（P相互作用<0.10）。在样品2中，WC的C指数（HR，0.84; 95% CI，0.73-0.95），增值税（HR，0.91; 95% CI，0.85-0.98）和肝脏衰减（HR，0.90; 95% CI，0.77-1.00）大于HbA 1c（HR，0.74; 95% CI，0.57-0.90），而HbA 1c在糖尿病前期最好（HR，0.72; 95% CI，0.66-0.78）。总体而言，在黑人成年人中，多种肥胖指标与糖尿病事件相关，预测能力中等。在血糖正常的黑人患者中，WC、肝脏衰减和VAT可以适当地识别糖尿病高危人群，而HbA 1c是糖尿病前期个体的最佳预测因子。
The prognostic value of anthropometric, adipokine, and computed tomography measures of adiposity to predict diabetes in Black, specifically by normoglycemia versus prediabetes, remains incompletely understood. Among Black participants without diabetes in the JHS (Jackson Heart Study), waist circumference [WC], body mass index, adiponectin, leptin, and leptin:adiponectin ratio were standardized in sample 1 (2422 participants at baseline [2000–2004]) and WC, body mass index, visceral adipose tissue (VAT), subcutaneous adipose tissue, and liver attenuation in 1537 participants at examination 2 (2005–2008) (sample 2). Hazard ratios (HRs) for diabetes were estimated using interval‐censored Cox modeling adjusting for traditional risk factors and validated with the C index. Over 5 years, 300 and 122 incident diabetes cases occurred in sample 1 and sample 2, respectively. In sample 1 and sample 2, a 1‐SD higher log‐leptin:adiponectin ratio and VAT had the strongest associations (HR, 1.95 [95% CI, 1.67–2.27] and 1.76 [95% CI, 1.52–2.04]) and discriminatory power (C index 0.68 [95% CI, 0.64–0.71] and C index 0.67 [95% CI, 0.61–0.74]) with diabetes. The normoglycemic compared with the prediabetes group had a 1.3 to 1.9 times greater magnitude of associations with diabetes for WC, liver attenuation, and VAT (P interaction <0.10). In sample 2, C indices for WC (HR, 0.84; 95% CI, 0.73–0.95), VAT (HR, 0.91; 95% CI, 0.85–0.98), and liver attenuation (HR, 0.90; 95% CI, 0.77–1.00) were greater than HbA1c (HR, 0.74; 95% CI, 0.57–0.90) in normoglycemia, whereas HbA1c was best in prediabetes (HR, 0.72; 95% CI, 0.66–0.78). Overall, among Black adults, multiple measures of adiposity were associated with incident diabetes with modest predictive ability. In Black patients with normoglycemia, WC, liver attenuation, and VAT may appropriately identify those at high risk for diabetes, whereas HbA1c was the best predictor in individuals with prediabetes.
影响因子：
16.2
作者：
MacKay MF;Haffner SM;Wagenknecht LE;D'Agostino RB Jr;Hanley AJ
通讯作者：
Hanley AJ