1
|
Deng H, Hu P, Li H, Zhou H, Wu X, Yuan M, Duan X, Lao M, Wu C, Zheng M, Lao XQ, Zhao W, Liu X. Novel lipid indicators and the risk of type 2 diabetes mellitus among Chinese hypertensive patients: findings from the Guangzhou Heart Study. Cardiovasc Diabetol 2022; 21:212. [PMID: 36243748 PMCID: PMC9571423 DOI: 10.1186/s12933-022-01660-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 10/03/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Data are limited on whether several easily measured indices are independent predictors of type 2 diabetes mellitus (T2DM) in hypertensive patients. This study aimed to assess the association of hypertriglyceridemic-waist phenotype, triglyceride glucose (TyG) index, lipid accumulation product (LAP), and visceral adiposity index (VAI) with T2DM risk in hypertensive patients. METHODS This cross-sectional study included 5321 hypertensive patients from the baseline survey of the Guangzhou Heart Study. Face-to-face questionnaire survey, physical examination, and fasting blood sample collection were completed for all subjects. Odds ratio (OR) with 95% confidence interval (95% CI) were calculated by using the logistic regression model. The potential nonlinear relationship was examined using restricted cubic spline regression. RESULTS The prevalence of T2DM was 19.98% among hypertensive patients. After adjusting for confounders, participants with elevated triglyceride levels and enlarged waist circumference (HTGW) were associated with a 2.57-fold risk of T2DM (OR 2.57, 95% CI 2.05, 3.23). When comparing with subjects within the lowest quartile of the indices, those in the highest quartile of TyG, LAP, and VAI were associated with 5.35-fold (95% CI 4.33, 6.64), 2.65-fold (95% CI 2.11, 3.34), and 2.17-fold (95% CI 1.77, 2.67) risk of T2DM after adjusting for confounders. Every 1-unit increment of TyG, LAP, and VAI was associated with 81%, 38%, and 31% increased risk of T2DM, respectively. The nonlinear association was observed for TyG, LAP, and VAI (all P Non-linear < 0.001). CONCLUSIONS The results found that among hypertensive patients, HTGW and a higher level of TyG, LAP, and VAI were associated with an elevated risk of T2DM. The findings suggested that HTGW, TyG, LAP, and VAI may serve as simple and effective tools for T2DM risk assessment in the prevention and management of main chronic diseases.
Collapse
Affiliation(s)
- Hai Deng
- grid.413405.70000 0004 1808 0686Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Science, Guangzhou, 510080 China
| | - Peng Hu
- grid.411847.f0000 0004 1804 4300School of Public Health, Guangdong Pharmaceutical University, No. 283 Jianghai Avenue, Haizhu District, Guangzhou, 510310 China ,grid.12981.330000 0001 2360 039XDepartment of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080 China
| | - Huoxing Li
- grid.284723.80000 0000 8877 7471The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515 China
| | - Huanning Zhou
- Guangzhou Yuexiu District Center for Disease Control and Prevention, Guangzhou, China
| | - Xiuyi Wu
- Nancun Community Health Service Center, Guangzhou, 511442 China
| | - Maohua Yuan
- Dadong Street Community Health Service Center, Guangzhou, 510080 China
| | - Xueru Duan
- grid.12981.330000 0001 2360 039XDepartment of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080 China
| | - Miaochao Lao
- Department of Sleep Center, Department of Geriatric Respiratory, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, 510080 China
| | - Chuchu Wu
- grid.411847.f0000 0004 1804 4300School of Public Health, Guangdong Pharmaceutical University, No. 283 Jianghai Avenue, Haizhu District, Guangzhou, 510310 China
| | - Murui Zheng
- grid.508371.80000 0004 1774 3337Department of Community Health, Guangzhou Center for Disease Control and Prevention, No. 1 Qide Road, Baiyun District, Guangzhou, 510440 China
| | - Xiang Qian Lao
- grid.10784.3a0000 0004 1937 0482JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, 999077 SAR China
| | - Wenjing Zhao
- grid.263817.90000 0004 1773 1790School of Public Health and Emergency Management, Southern University of Science and Technology, No. 1088 Xueyuan Avenue, Shenzhen, 518055 China
| | - Xudong Liu
- grid.411847.f0000 0004 1804 4300School of Public Health, Guangdong Pharmaceutical University, No. 283 Jianghai Avenue, Haizhu District, Guangzhou, 510310 China
| |
Collapse
|
2
|
Yang M, Xu Y, Hu C, Zhang S, Kuang M, Zou Y. Association between hypertriglyceridemic-waist phenotype and non-alcoholic fatty liver disease: a general population-based study. Lipids Health Dis 2022; 21:50. [PMID: 35655216 PMCID: PMC9161496 DOI: 10.1186/s12944-022-01660-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 05/23/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hypertriglyceridemic-waist (HTGW) phenotype has been proposed as a practical tool for screening the risk of cardiovascular diseases and glycemic metabolic disease. This study sought to investigate the relationship between HTGW phenotype and non-alcoholic fatty liver disease (NAFLD). METHODS A total of 14,251 subjects who took part in health screening were enrolled in the study and NAFLD was diagnosed by abdominal ultrasound. According to triglyceride (TG) and waist circumference, the study population was divided into four phenotypes, in which HTGW phenotype was defined as TG ≥ 1.7 mmol/L and male waist circumference ≥ 90 cm or female waist circumference ≥ 80 cm. Multivariate logistic regression analysis was used to evaluate the relationship between HTGW phenotype and NAFLD. RESULTS In the current study, 2.43% of the subjects had HTGW phenotype, while the prevalence of NAFLD in subjects with HTGW phenotype was 77.81%. After full adjustment for covariates, compared with people with normal waist circumference and TG levels, the risk of NAFLD in people with normal TG levels but enlarged waist circumference increased by 39% [OR:1.39, 95%CI: 1.15, 1.68], in people with normal waist circumference but elevated TG levels increased by 96% [OR:1.96, 95%CI: 1.65, 2.33], and in subjects with HTGW phenotype increased by 160% [OR:2.60, 95%CI: 1.88, 3.58]. Additionally, further analysis suggested that there were significant interactions between age, height, BMI and NAFLD risk associated with TGW phenotypes. Receiver operating characteristic curves analysis suggested that the combination of TG and waist circumference further improved the diagnostic value for NAFLD. CONCLUSIONS HTGW phenotype is associated with NAFLD risk in the general population, which may be a novel and accessible indicator for NAFLD screening.
Collapse
Affiliation(s)
- Ming Yang
- Department of Cardiology, Jiangxi Provincial People's Hospital, Nanchang, 330006, Jiangxi, China
| | - Yaqin Xu
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Chong Hu
- Department of Gastroenterology, Jiangxi Provincial People's Hospital, Nanchang, 330006, Jiangxi, China
| | - Shuhua Zhang
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, Nanchang, 330006, Jiangxi, China
| | - Maobin Kuang
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, Nanchang, 330006, Jiangxi, China
| | - Yang Zou
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, Nanchang, 330006, Jiangxi, China.
| |
Collapse
|
3
|
Qiao S, Gao W, Guo S. Neutrophil-Lymphocyte Ratio (NLR) for Predicting Clinical Outcomes in Patients with Coronary Artery Disease and Type 2 Diabetes Mellitus: A Propensity Score Matching Analysis. Ther Clin Risk Manag 2020; 16:437-443. [PMID: 32547040 PMCID: PMC7245465 DOI: 10.2147/tcrm.s244623] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 04/03/2020] [Indexed: 12/13/2022] Open
Abstract
Background Cardiovascular diseases (CVD) combined with Type 2 diabetes mellitus (T2DM) frequently occurred. In this study, we aimed at exploring the prognostic significance of blood neutrophil–lymphocyte ratio (NLR) in these types of patients. Patients and Methods Between June 30, 2010 and August 30, 2017, 1454 patients with CVD were enrolled in this study. Kaplan and Meier methodology was used for survival analysis. We also used propensity score matching (PSM) to further compare survival in patients with or without T2DM. Results Among all patients, we applied ROC curve analysis to stratify all patients into two different groups including NLR >2.5 (n=432) and NLR≤ 2.5 (n=1022) groups. After that, we further performed survival analysis between different groups. We found that patients with NLR ≤2.5 had significantly favorable OS compared with the overall survival in patients with NLR >2.5. We further built the PSM using 242 pairs of patients who have CVD and with or without T2DM. After adjusting for competing risk factors, we performed Cox proportional hazards models to identify the independent prognostic factors in multivariable adjustment. We found that NLR ≤2.5 (HR: 2.576, 95% CI: 1.241–4.583, P =0.001) and extent of coronary artery disease (HR: 2.432, 95% CI: 1.189–4.392, P =0.005) remained independent predictors of OS. Conclusion In conclusion, we have established an PSM model and found that a high NLR value was an independent prognostic factor for survival, predicting in patients with both CAD and T2DM. The NLR value would be a valuable biomarker to evaluate the outcomes of patients and give them opportunities for choosing alternative therapies.
Collapse
Affiliation(s)
- Shang Qiao
- Department of Cardiology, Bayan Nur Hospital of the Nei Monggol Autonomous Region, Bayan Nur City 015000, People's Republic of China
| | - Wen Gao
- Department of Cardiology, Bayan Nur Hospital of the Nei Monggol Autonomous Region, Bayan Nur City 015000, People's Republic of China
| | - Shujun Guo
- Department of Cardiology, Bayan Nur Hospital of the Nei Monggol Autonomous Region, Bayan Nur City 015000, People's Republic of China
| |
Collapse
|
4
|
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.
Collapse
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
| |
Collapse
|