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Xu M, Huang M, Qiang D, Gu J, Li Y, Pan Y, Yao X, Xu W, Tao Y, Zhou Y, Ma H. Hypertriglyceridemic Waist Phenotype and Lipid Accumulation Product: Two Comprehensive Obese Indicators of Waist Circumference and Triglyceride to Predict Type 2 Diabetes Mellitus in Chinese Population. J Diabetes Res 2020; 2020:9157430. [PMID: 33344653 PMCID: PMC7725575 DOI: 10.1155/2020/9157430] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 08/23/2020] [Accepted: 11/19/2020] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To determine whether hypertriglyceridemic waist (HTGW) and high lipid accumulation product (LAP) preceded the incidence of type 2 diabetes mellitus (T2DM), and to investigate the interactions of HTGW and LAP with other components of metabolic syndrome on the risk of T2DM. METHODS A total of 15,717 eligible participants without baseline T2DM and aged 35 and over were included from a Chinese rural cohort. Cox proportional hazards regression models were used to estimate the association of HTGW and LAP with the incidence of T2DM, and the restricted cubic spline model was used to evaluate the dose-response association. RESULTS Overall, 867 new T2DM cases were diagnosed after 7.77 years of follow-up. Participants with HTGW had a higher hazard ratio for T2DM (hazard ratio (HR): 6.249, 95% confidence interval (CI): 5.199-7.511) after adjustment for potential confounders. The risk of incident T2DM was increased with quartiles 3 and 4 versus quartile 1 of LAP, and the adjusted HRs (95% CIs) were 2.903 (2.226-3.784) and 6.298 (4.911-8.077), respectively. There were additive interactions of HTGW (synergy index (SI): 1.678, 95% CI: 1.358-2.072) and high LAP (SI: 1.701, 95% CI: 1.406-2.059) with increased fasting plasma glucose (FPG) on the risk of T2DM. Additionally, a nonlinear (P nonlinear < 0.001) dose-response association was found between LAP and T2DM. CONCLUSION The subjects with HTGW and high LAP were at high risk of developing T2DM, and the association between LAP and the risk of T2DM may be nonlinear. Our study further demonstrates additive interactions of HTGW and high LAP with increased FPG on the risk of T2DM.
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Affiliation(s)
- Minrui Xu
- Wujin District Center for Disease Prevention and Control, Changzhou, Jiangsu, China
| | - Mingtao Huang
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Department of Epidemiology, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
- Department of Prenatal Diagnosis, Nanjing Maternity and Child Health Care Hospital, Women's Hospital of Nanjing Medical University, Nanjing, China
| | - Deren Qiang
- Wujin District Center for Disease Prevention and Control, Changzhou, Jiangsu, China
| | - Jianxin Gu
- Wujin District Center for Disease Prevention and Control, Changzhou, Jiangsu, China
| | - Yong Li
- Wujin District Center for Disease Prevention and Control, Changzhou, Jiangsu, China
| | - Yingzi Pan
- Wujin District Center for Disease Prevention and Control, Changzhou, Jiangsu, China
| | - Xingjuan Yao
- Changzhou Center for Disease Prevention and Control, Changzhou, Jiangsu, China
| | - Wenchao Xu
- Changzhou Center for Disease Prevention and Control, Changzhou, Jiangsu, China
| | - Yuan Tao
- Department of Medical Affairs, The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou, Changzhou, Jiangsu, China
| | - Yihong Zhou
- Wujin District Center for Disease Prevention and Control, Changzhou, Jiangsu, China
| | - Hongxia Ma
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Department of Epidemiology, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
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Ren Y, Liu Y, Sun X, Deng K, Wang C, Li L, Zhang L, Wang B, Zhao Y, Zhou J, Han C, Zhang H, Yang X, Luo X, Pang C, Yin L, Feng T, Zhao J, Zhang M, Hu D. Hypertriglyceridemia-waist and risk of developing type 2 diabetes: The Rural Chinese Cohort Study. Sci Rep 2017; 7:9072. [PMID: 28831093 PMCID: PMC5567308 DOI: 10.1038/s41598-017-09136-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 07/20/2017] [Indexed: 12/15/2022] Open
Abstract
Limited information is available on the effect of hypertriglyceridemia–waist (HTGW) combination and its dynamic status on the risk of type 2 diabetes mellitus (T2DM) in rural China. A cohort of 12,086 participants 18 to 92 years old was retained in this study. Kaplan-Meier analysis yielded the cumulative incidence of T2DM for each phenotype group (based on TG level and waist circumference [WC] at baseline). Cox regression yielded hazard ratios relating HTGW (based on TG level and WC at baseline and follow-up) to risk of developing T2DM. After a median follow-up of 6.0 years (71,432 person-years of follow-up), T2DM developed in 621 participants. For HTGW participants, the incidence of T2DM was 26.4/1000, 20.6/1000, and 21.9/1000 person-years for males, females, and overall, respectively. The adjusted HR for HTGW associated with T2DM was 7.63 (95% CI 4.32–13.49) for males and 7.75 (4.71–12.78) for females. Compared with consistent HTGW, with transformation from baseline HTGW to normal WC and normal triglycerides level at follow-up, the risk of developing T2DM was reduced by 75% and 78% for males and females. HTGW is a major risk factor for T2DM, but the risk could be reduced by improved triglycerides level and WC.
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Affiliation(s)
- Yongcheng Ren
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yu Liu
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Xizhuo Sun
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Kunpeng Deng
- Yantian Entry-exit Inspection and Quarantine Bureau, Shenzhen, Guangdong, People's Republic of China
| | - Chongjian Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Linlin Li
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Lu Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Bingyuan Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yang Zhao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Junmei Zhou
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Chengyi Han
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Hongyan Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Xiangyu Yang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Xinping Luo
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Chao Pang
- Department of Prevention and Health Care, Military Hospital of Henan Province, Zhengzhou, Henan, People's Republic of China
| | - Lei Yin
- Department of Prevention and Health Care, Military Hospital of Henan Province, Zhengzhou, Henan, People's Republic of China
| | - Tianping Feng
- Department of Prevention and Health Care, Military Hospital of Henan Province, Zhengzhou, Henan, People's Republic of China
| | - Jingzhi Zhao
- Department of Prevention and Health Care, Military Hospital of Henan Province, Zhengzhou, Henan, People's Republic of China
| | - Ming Zhang
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Dongsheng Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
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Association Between the Hypertriglyceridemic Waist Phenotype, Prediabetes, and Diabetes Mellitus Among Adults in Puerto Rico. J Immigr Minor Health 2017; 18:102-9. [PMID: 24519258 DOI: 10.1007/s10903-014-9985-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
This study assessed the association of the hypertriglyceridemic waist (HTGW) phenotype with prediabetes and diabetes (DM) in a group of Hispanics. Analysis of a cross-sectional study of 858 adults residing in Puerto Rico that collected data on blood pressure, biochemical, and anthropometric measurements was performed. HTGW phenotype was defined as elevated triglycerides and elevated waist circumference. Prediabetes was defined as a fasting glucose of 100-125 mg/dL and DM as a fasting glucose ≥126 mg/dL or prior diagnosis. Prevalence of HTGW, prediabetes, and DM was 27.9, 38.0, and 21.6 %, respectively. Subjects with the HTGW phenotype had higher adjusted odds of prediabetes (POR 5.55; 95 % CI 3.38-9.13) and DM (POR 7.28; 95 % CI 3.63-14.63) compared to those without the phenotype. The association for prediabetes was stronger for women than among men. HTGW phenotype was strongly associated with prediabetes and DM, reinforcing the need to further assess its performance as a screening tool to identify at-risk individuals for cardiometabolic conditions.
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Chen S, Guo X, Yu S, Yang H, Sun G, Li Z, Sun Y. Hypertriglyceridemic waist phenotype and metabolic abnormalities in hypertensive adults: A STROBE compliant study. Medicine (Baltimore) 2016; 95:e5613. [PMID: 27930589 PMCID: PMC5266061 DOI: 10.1097/md.0000000000005613] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The aim of this study was to evaluate the relationship between the hypertriglyceridemic waist (HTGW) phenotype and metabolic abnormalities in hypertensive adults.A cross-sectional study, with a sample of 5919 hypertensive adults (2892 men and 3027 women) aged 35 years or older, was recruited from rural areas of China. The participants underwent anthropometric measurements and laboratory examinations. The self-reported information was collected by trained personnel. The HTGW phenotype was defined as elevated triglycerides and elevated waist circumference. The logistic regression analysis was used to evaluate the associations of interest.Hypertensive adults with the HTGW phenotype had significantly higher prevalences of all cardiometabolic risk factors than those without the HTGW phenotype (P < 0.001). Compared with the normal waist normal triglyceride (NWNT) group, hypertensive adults with the HTGW phenotype had much higher possibilities to have all cardiometabolic risk factors, especially for 8.35 times more likely of having ≥3 cardiometabolic risk factors [95% confidence interval (95% CI) 5.92-11.79], 6.14 times more likely of having low HDL cholesterol (95% CI 4.98-7.58), 5.49 times more likely of having hyperuricemia (95% CI 4.40-6.86), and 4.32 times more likely of having 1 to 2 cardiometabolic risk factors (95% CI 3.68-5.07) (P < 0.001). Multivariate analysis indicated that the HTGW phenotype was positively associated with metabolic abnormalities (P < 0.05).This study concluded that the HTGW phenotype was positively associated with metabolic abnormalities in hypertensive adults. The HTGW phenotype showed to be an important tool for monitoring of hypertensive adults with metabolic abnormalities, which is low cost, simple, and useful in clinical practice, especially in primary health care in the rural area of China.
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Ren Y, Zhang M, Zhao J, Wang C, Luo X, Zhang J, Zhu T, Li X, Yin L, Pang C, Feng T, Wang B, Zhang L, Li L, Yang X, Zhang H, Hu D. Association of the hypertriglyceridemic waist phenotype and type 2 diabetes mellitus among adults in China. J Diabetes Investig 2016; 7:689-94. [PMID: 27181875 PMCID: PMC5009130 DOI: 10.1111/jdi.12489] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 01/03/2016] [Accepted: 01/27/2016] [Indexed: 12/15/2022] Open
Abstract
AIMS/INTRODUCTION To clarify the association of the hypertriglyceridemic waist phenotype and type 2 diabetes mellitus among adults in China. MATERIALS AND METHODS In the present case-control study, we included 1,685 patients with type 2 diabetes mellitus and 7,141 normal glucose-tolerant controls from the Henan Province of China in 2011. Elevated waist circumference (GW) was defined as ≥90 cm for men and ≥80 cm for women. Hypertriglyceridemia (HT) was defined as >1.7 m mol/L triglycerides (TG) level. The association of hypertriglyceridemic waist phenotype and type 2 diabetes mellitus was investigated by sex, body mass index, physical activity, and family history of diabetes. RESULTS Cases and controls differed in age, waist circumference (WC), weight, TG level, fasting glucose, body mass index, smoking status, diabetic family history, physical activity and hypertriglyceridemic waist phenotype (P < 0.05), but not alcohol drinking (P = 0.63). In the overall sample, as compared with the phenotype of normal TG level and normal WC (NTNW), normal TG level/enlarged WC (NTGW), elevated TG level/normal WC (HTNW) and elevated TG level/enlarged WC (HTGW) were associated with type 2 diabetes mellitus (odds ratio 4.14, 2.42 and 6.23, respectively). Only HTGW was consistently associated with risk of type 2 diabetes mellitus, with or without adjustment. The strongest relationship between HTGW and type 2 diabetes mellitus was for subjects with body mass index <24.0 kg/m(2) (odds ratio 6.54, 95% confidence interval 4.22-10.14) after adjustment for cofounding variables. CONCLUSION HTGW was stably and significantly associated with risk of type 2 diabetes mellitus in adult Chinese.
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Affiliation(s)
- Yongcheng Ren
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Ming Zhang
- Department of Preventive Medicine, Shenzhen University School of Medicine, Shenzhen, China
| | - Jingzhi Zhao
- Department of Prevention and Health Care, Military Hospital of Henan Province, Zhengzhou, China
| | - Chongjian Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xinping Luo
- Department of Preventive Medicine, Shenzhen University School of Medicine, Shenzhen, China
| | - Jiatong Zhang
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Tian Zhu
- Department of Clinical Medicine, Shenzhen University School of Medicine, Shenzhen, China
| | - Xi Li
- Department of Preventive Medicine, School of Public Health, Guiyang Medical University, Guiyang, China
| | - Lei Yin
- Department of Prevention and Health Care, Military Hospital of Henan Province, Zhengzhou, China
| | - Chao Pang
- Department of Prevention and Health Care, Military Hospital of Henan Province, Zhengzhou, China
| | - Tianping Feng
- Department of Prevention and Health Care, Military Hospital of Henan Province, Zhengzhou, China
| | - Bingyuan Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China.,Department of Preventive Medicine, Shenzhen University School of Medicine, Shenzhen, China
| | - Lu Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China.,Department of Preventive Medicine, Shenzhen University School of Medicine, Shenzhen, China
| | - Linlin Li
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xiangyu Yang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China.,Department of Preventive Medicine, Shenzhen University School of Medicine, Shenzhen, China
| | - Hongyan Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China.,Department of Preventive Medicine, Shenzhen University School of Medicine, Shenzhen, China
| | - Dongsheng Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
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Lee BJ, Nam J, Kim JY. Predictors of metabolic abnormalities in phenotypes that combined anthropometric indices and triglycerides. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 16:59. [PMID: 26861162 PMCID: PMC4748450 DOI: 10.1186/s12906-016-1024-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 01/27/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND The hypertriglyceridemic waist (HW) phenotype has been shown to be strongly associated with metabolic abnormalities; however, to date, no study has reported the prediction of metabolic abnormalities using the HW phenotype along with waist circumference (WC) and the triglyceride (TG) level or various phenotypes consisting of an individual anthropometric index combined with the TG level. The objectives of this study were to assess the association of the HW phenotype with metabolic abnormalities in Korean women and to evaluate the predictive powers of various phenotypes with regard to metabolic abnormalities. METHODS Total cholesterol (TC), high- and low-density lipoprotein (HDL and LDL) cholesterol, and TG levels, systolic and diastolic blood pressures (SBP and DBP), and anthropometric indices were measured in 7661 women. The Naive Bayes algorithm and logistic regression were used to determine the predictive powers of the models using different phenotypes. RESULTS The HW phenotype demonstrated the strongest association with all metabolic components. The best phenotypic predictors were the forehead-to-rib circumference ratio + TG for the HDL level, age + TG for the LDL level, age + TG for SBP, and rib circumference + TG and neck circumference + TG for DBP. The associations between TG and TC or HDL were higher compared with those between WC and TC or HDL, whereas the associations between WC and SBP or DBP were higher compared with those between TG and SBP or DBP. Age was strongly associated with hypercholesterolemia, the HDL and LDL cholesterol levels, and SBP and had good predictive power, but not with respect to DBP. CONCLUSIONS We have determined that the HW phenotype is a useful indicator of metabolic abnormalities in Korean women; although HW had the strongest association with metabolic abnormalities, the best phenotype combination consisting of a single anthropometric index and the TG level may differ depending on the metabolic factors in question. Our findings provide insights into the detection of metabolic abnormalities in complementary and alternative medicine.
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Affiliation(s)
- Bum Ju Lee
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, 1672 Yuseongdae-ro, Yuseong-gu, Deajeon 305-811 Republic of Korea
| | - Jiho Nam
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, 1672 Yuseongdae-ro, Yuseong-gu, Deajeon 305-811 Republic of Korea
| | - Jong Yeol Kim
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, 1672 Yuseongdae-ro, Yuseong-gu, Deajeon 305-811 Republic of Korea
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Tangvarasittichai S, Seangsuk C, Chaisomboon C, Meemark S, Tangvarasittichai O. Association of abdominal obesity, hypertriglyceridemia, and hypertriglyceridemic waist phenotype with hypertension and type 2 diabetes mellitus. Int J Diabetes Dev Ctries 2015. [DOI: 10.1007/s13410-015-0302-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Lee BJ, Kim JY. Identification of Type 2 Diabetes Risk Factors Using Phenotypes Consisting of Anthropometry and Triglycerides based on Machine Learning. IEEE J Biomed Health Inform 2015; 20:39-46. [PMID: 25675467 DOI: 10.1109/jbhi.2015.2396520] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The hypertriglyceridemic waist (HW) phenotype is strongly associated with type 2 diabetes; however, to date, no study has assessed the predictive power of phenotypes based on individual anthropometric measurements and triglyceride (TG) levels. The aims of the present study were to assess the association between the HW phenotype and type 2 diabetes in Korean adults and to evaluate the predictive power of various phenotypes consisting of combinations of individual anthropometric measurements and TG levels. Between November 2006 and August 2013, 11,937 subjects participated in this retrospective cross-sectional study. We measured fasting plasma glucose and TG levels and performed anthropometric measurements. We employed binary logistic regression (LR) to examine statistically significant differences between normal subjects and those with type 2 diabetes using HW and individual anthropometric measurements. For more reliable prediction results, two machine learning algorithms, naive Bayes (NB) and LR, were used to evaluate the predictive power of various phenotypes. All prediction experiments were performed using a tenfold cross validation method. Among all of the variables, the presence of HW was most strongly associated with type 2 diabetes (p < 0.001, adjusted odds ratio (OR) = 2.07 [95% CI, 1.72-2.49] in men; p < 0.001, adjusted OR = 2.09 [1.79-2.45] in women). When comparing waist circumference (WC) and TG levels as components of the HW phenotype, the association between WC and type 2 diabetes was greater than the association between TG and type 2 diabetes. The phenotypes tended to have higher predictive power in women than in men. Among the phenotypes, the best predictors of type 2 diabetes were waist-to-hip ratio + TG in men (AUC by NB = 0.653, AUC by LR = 0.661) and rib-to-hip ratio + TG in women (AUC by NB = 0.73, AUC by LR = 0.735). Although the presence of HW demonstrated the strongest association with type 2 diabetes, the predictive power of the combined measurements of the actual WC and TG values may not be the best manner of predicting type 2 diabetes. Our findings may provide clinical information concerning the development of clinical decision support systems for the initial screening of type 2 diabetes.
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