scholarly journals Association between Hypertriglyceridemic-Waist Phenotype and Risk of Type 2 Diabetes Mellitus in Middle-Aged and Older Chinese Population: A Longitudinal Cohort Study

Author(s):  
Dezhong Chen ◽  
Ziyun Liang ◽  
Huimin Sun ◽  
Ciyong Lu ◽  
Weiqing Chen ◽  
...  

Current evidence remains inconsistent with regard to the association between different triglyceridemic-waist phenotypes and the risks for type 2 diabetes mellitus (T2DM). We aimed to investigate this association among a retrospective cohort analysis of 6918 participants aged ≥ 45 years in the China Health and Retirement Longitudinal Study (CHARLS). Participants were categorized into four triglyceridemic-waist phenotypes consisting of NWNT (normal waist circumference and normal triglycerides), NWHT (normal waist circumference and high triglycerides), EWNT (enlarged waist circumference and normal triglycerides), and EWHT (enlarged waist circumference and high triglycerides) based on participants’ baseline information. Multivariate log-binomial regression was used to assess the T2DM risk in different phenotypes. Subgroup analysis was conducted to test the robustness of the findings. After 4-years of follow-up, participants with EWHT (Relative Risk [RR]: 1.909, 95% Confidence Interval [CI]: 1.499 to 2.447) or EWNT (RR: 1.580, 95%CI: 1.265 to 1.972) phenotypes had significantly higher likelihood of incident T2DM compared to the NWNT phenotype, whereas the association was not significant for the NWHT phenotype (RR: 1.063, 95%CI: 0.793 to 1.425). The subgroup analyses generally revealed similar associations across all subgroups. Among middle-aged and older adults, we suggested a combined use of waist circumference and triglycerides measures in identifying participants who are at high risk of developing T2DM.

2021 ◽  
Vol 12 ◽  
Author(s):  
Jinyue Yu ◽  
Qian Yi ◽  
Leying Hou ◽  
Ge Chen ◽  
Yaojia Shen ◽  
...  

BackgroundLipid accumulation product (LAP), a product of waist circumference (WC) and fasting triglycerides (TG), is a measure of lipid accumulation and an effective predictor of metabolic syndrome. This study aimed to evaluate the associations of LAP and its longitudinal transitions with type 2 diabetes mellitus (T2DM) among middle-aged and older Chinese.MethodsData were extracted from the China Health and Retirement Longitudinal Study (2011, 2013, 2015, and 2018). LAP was defined as (WC-65) ×TG for men, and (WC-58) ×TG for women. Participants were classified into high- and low-LAP groups at baseline, and subsequently into four transition patterns during 2011-2015: maintained-high, maintained-low, high-to-low, and low-to-high LAP. The longitudinal transition patterns of LAP on the development of T2DM were assessed by multivariable Cox frailty models.ResultsOverall, 7397 participants were included for analysis, among whom 849 (11.5%) developed T2DM between 2011 and 2018. Women with high-LAP levels at baseline presented a higher risk of T2DM (hazard ratios [HR]=1.37, 95% confidence interval [CI]: 1.07-1.77), while no significant association was found in men. Compared with women with maintained-low LAP pattern, those with transition patterns of low-to-high LAP and maintained-high LAP were at higher risk of T2DM (HR =1.99 and 1.98, both P<0.05); however, for men, the significantly positive association was only observed in maintained-high LAP transition pattern (HR=1.53, 95% CI: 1.04-2.23).ConclusionsElevated LAP levels and the transition patterns of maintained-high LAP and low-to-high LAP are significant risk factors for T2DM in women. Preventions are needed to combat T2DM at an early dyslipidemic stage.


Author(s):  
Ge Chen ◽  
Qian Yi ◽  
Leying Hou ◽  
Shenghan Peng ◽  
Mengya Fan ◽  
...  

The rapid economic growth and nutritional changes in China have brought an increased burden of type 2 diabetes mellitus (T2DM). This study aimed to assess the effects of hypertriglyceridemic-waist (HTW) and its dynamic transitions on incident T2DM among middle-aged and older Chinese. Data were extracted from the China Health and Retirement Longitudinal Study (CHARLS). Participants were classified into three HTW phenotypes, namely NTNW (normal triglyceride (TG) and waist circumference (WC)), NTEW/ETNW (normal TG and enlarged WC, or elevated TG and normal WC) and ETEW (elevated TG and enlarged WC). Multivariable Cox frailty models were used to assess the associations of HTW phenotypes and their transitions over time with the risk of T2DM. A total of 7397 subjects without T2DM were included, of which 849 developed T2DM during 2011–2018. Compared with individuals with NTNW, people in the NTEW/ETNW group and ETEW group were at a significantly higher risk of T2DM (HRNTEW/ETNW = 1.28, 95% CI: 1.06–1.54 and HRETEW = 1.61, 95% CI: 1.26–2.06). For subjects with NTNW at baseline, the risk of developing T2DM increased by 38% and 83% if their metabolic status changed to NTEW/ETNW and ETEW, respectively. For subjects with NTEW/ETNW, the risk of T2DM decreased by 33% when their metabolic status changed to normal (NTNW); but the risk increased by 49% if the status became more serious (ETEW). NTEW/ETNW, ETEW and their transitions to adverse states were risk factors for T2DM.


2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Lingling Xu ◽  
Weihong Yu ◽  
Ping Huang ◽  
Chunying Li ◽  
Yan Li ◽  
...  

Objective. To examine the association of three most common obesity measures including body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) with chronic kidney disease (CKD) risk in patients with type 2 diabetes mellitus (T2D).Design. Cross-sectional evaluation of the effect of anthropometric measures on CKD risk.Setting. Outpatient Department.Subjects. T2D patients who were treated between October 2012 and May 2013.Intervention. None.Main Outcome Measure. CKD risk.Results. On average, the patients had a mean age of 60.2 years, and 40% were males. CKD was present in 46% of all the patients. In multivariate logistic regression using the imputed data, higher WC was associated with greater odds of CKD (OR = 1.019, 95% CI = 1.002–1.006,P=0.030), but not BMI and WHR. Interestingly, we found that patients with very small WC seemed to have greater odds of CKD. We observed age-specific effect of WC such that the effect of WC on CKD risk is significant only in middle-aged T2D patients.Conclusion. Our study provides evidence for the association of WC with CKD in Chinese patients with T2D. T2D patients, especially middle-aged T2D patients, should reduce their WC to decrease CKD risk.


2020 ◽  
Vol 15 ◽  
Author(s):  
Jim Philip ◽  
Cornelius James Fernandez

: Meglitinides are a group of oral hypoglycemic medications currently approved for the treatment of type 2 diabetes mellitus (T2DM). Two meglitinide molecules, Repaglinide and Nateglinide,are presently in use. Repaglinide is preferred because of its superior glycemic efficacy.They have modest efficacy with a mean decrement of glycosylated haemoglobin (HbA1c) ranging between -0.2 to -1.50% with individual therapy. Additional HbA1c reduction can occur with combination therapy with other oral hypoglycemics. This class of drugs is effective in controlling postprandial hyperglycemia with minimal risk of hypoglycemia.It is also useful in patients in with variable meal timings, especially in the elderly, and in patients with renal failure. There are is a dearth of long-term studies on meglitinides to assess cardiovascular outcomes or mortality in T2DM,although the Nateglinide and Valsartan in Impaired Glucose ToleranceOutcomes Research (NAVIGATOR) study showed no difference between Nateglinide and placebo with regard to the core composite cardiovascular outcomes. Based on a PubMed literature search using key words: ‘meglitinides’, ‘repaglinide’, ‘nateglinide’, ‘HbA1c’, ‘glycated haemoglobin’, ‘cardiovascular safety’, ‘cardiovascular events’, ‘cardiovascular outcome trials’, ‘type 2 diabetes mellitus’ and heart failure, and combining the search terms using Boolean operators ‘AND’, ‘OR’ and ‘NOT’ as needed we compiled current evidence for use of these oral hypoglycemic agents in clinical use. This article is an attempt to review the efficacy and cardiovascular (CV) safety of Meglitinides to help clinicians to use this class of oral hypoglycaemic agents prudently.


2009 ◽  
Vol 1280 ◽  
pp. 186-194 ◽  
Author(s):  
Hannah Bruehl ◽  
Oliver T. Wolf ◽  
Victoria Sweat ◽  
Aziz Tirsi ◽  
Stephen Richardson ◽  
...  

2020 ◽  
Vol 2 (2) ◽  
pp. 94
Author(s):  
Hafizha Firdaus Al-Fuady ◽  
Bambang Purwanto ◽  
Soebagijo Adi Soelistijo

AbstrakLatar Belakang: Diabetes melitus tipe 2 menjadi penyebab kematian nomer 3 di Indonesia. Kelebihan berat badan atau lingkar pinggang diatas normal dan kadar HDL-c rendah merupakan faktor risiko diabetes melitus tipe 2. Faktor risiko tersebut dapat diatasi salah satunya dengan olahraga. Senam PERSADIA 1 dirancang khusus untuk pencegahan diabetes. Namun, efek dari senam ini dalam menurunkan lingkar pinggang dan meningkatkan rasio HDL-c LDL-c belum pernah diteliti.Metode: Desain penelitian ini adalah eksperimen lapangan. Pengaruh Senam PERSADIA 1 terhadap lingkar pinggang dan rasio HDL-c LDL-c dianalisis dengan uji statistik deskriptif, uji normalitas saphiro wilk-test, uji beda berpasangan paired t-test / Wilcoxon-test.Hasil: Penelitian ini melibatkan 12 ibu-ibu PKK Lidah Wetan Gang V RW 2 Surabaya. Dari hasil analisis, terdapat penurunan rerata lingkar pinggang dan bermakna namun sedikit (p= 0,032), tidak ada peningkatan kadar HDL-c yang bermakna (p= 0,301), terdapat penurunan rerata LDL-c namun belum bermakna (p= 0,755), terdapat peningkatan rerata rasio HDL-c LDL-c namun belum bermakna (p= 0,303).Kesimpulan: Senam PERSADIA 1 dapat menurunkan lingkar pinggang namun sedikit dan belum dapat meningkatkan rasio HDL-c/LDL-c pada wanita secara bermakna menurut statistika. Diperlukan penelitian lebih lanjut dengan menambah waktu pelaksaan senam dan mengontrol energy intake subjek penelitian. Kata Kunci:. Diabetes melitus, Senam PERSADIA 1, lingkar pinggang, rasio HDL-c LDL-c, wanita AbstractBackground: Type 2 diabetes mellitus is the third causes of death in Indonesia. Overweight or waist circumference above normal and low HDL-c levels are risk factors for type 2 diabetes mellitus. One of the risk factors can be resolve with exercise. First series PERSADIA exercise is specifically designed for the prevention of diabetes. Howefer, the effect of this exercise in reducing waist circumference and increase ratio HDL-c LDL-c had never been proven.Method: The design of this study was a field experiment. The effect of first series PERSADIA exercise on waist circumference and HDL-c LDL-c ratio was analyzed by descriptive statistical test, saphiro wilk-test for normality test, paired t-test / Wilcoxon-test for different paired test.Result: This study involved 12 Women lived in Lidah Wetan Gang V RW 2 Surabaya. From the analysis, there was a decrease in mean waist circumference and significant but slightly (p = 0.032), there was no significant increase in HDL-c levels (p = 0.301), there was a decrease in LDL-c mean but it was not significant (p = 0.755), there was an increase in the mean HDL-c LDL-c ratio but it was not significant (p = 0.303).Conclusion: First series PERSADIA exercise has been able to reduce waist circumference but slightly and not able to increase HDL-c / LDL-c ratio significantly in women according to statistics. Further research is needed by increasing the exercise time and controlling the energy intake of subjects. Keywords: diabetes mellitus, first series PERSADIA exercise, waist circumference, HDL-c LDL-c ratio, women 


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