Capacity of different anthropometric measures to predict diabetes in a Chinese population in southwest China: a 15-year prospective study

Association between periodontitis and cardiometabolic index (CMI): a study from NHANES 2009-2014

Cardiometabolic index (CMI) is a novel anthropometric metric that integrates lipid and adiposity characteristics. The correlation between periodontitis development and CMI is ambiguous. The objective of this study was to establish the association between CMI and periodontitis by analyzing data from the NHANES (National Health and Nutrition Examination Survey) database. A cross-sectional study was conducted on a cohort of 6188 people selected from the NHANES database, covering the period from 2009 to 2014. The study employed multivariate logistic regression to examine the independent correlation between CMI and periodontitis. Subgroup data were analyzed and interaction tests were conducted to assess the impact of variables on the correlation between CMI and periodontitis. The CMI index was significantly and positively associated with the presence of periodontitis (β = 0.03, 95%CI(0.01, 0.05), p = 0.0092). In addition, a U-shaped relationship was found between CMI index and periodontitis severity in an older American population (65 < = age < = 80, with a folding point of 1.44, p = 0.008). This study demonstrates a significant correlation between CMI and periodontitis, positioning CMI as a crucial indicator for assessing periodontal health. Future efforts should prioritize oral hygiene interventions for patients with elevated CMI levels to facilitate early intervention and enhance overall health outcomes.

The relationship between dietary phytochemical index and novel anthropometric indices and the severity of diabetic foot ulcers in adults with type 2 diabetes: a cross-sectional study

BACKGROUND

Research on the relationship between dietary phytochemical intake and the anthropometric indices as well as the diabetic foot ulcers (DFUs) remains inconsistent. We aimed to investigate the associations of dietary phytochemical index (DPI) with the novel anthropometric indices and the severity of DFUs.

METHODS

This cross-sectional study was conducted on 339 adults with type 2 diabetes. Dietary intake was assessed using three 24-hour dietary recalls. To quantify the phytochemical content of the diet, the DPI estimation was done through an equation proposed by McCarty. The International Working Group on the Diabetic Foot (IWGDF) criteria and Wagner classification system were applied to assess DFUs. New anthropometric indices including a body shape index (ABSI), body roundness index (BRI) and abdominal volume index (AVI) were calculated based on formulas. We employed analysis of variance (ANOVA), analysis of covariance (ANCOVA) and logistic regression to explore associations between DPI and the anthropometric indices and DFU variables.

RESULTS

Our results revealed no significant association between DPI and the foot ulcer indices, following adjusting for the possible covariates. Furthermore, we also examined the relationship between diabetic neuropathy, as measured by monofilament score, and the DPI. Similarly, we did not find any substantial relationship between the DPI and monofilament score (OR: 1.18; 95% CI: 0.66-2.09; Ptrend = 0.56), as well as biochemical indices. Our analysis did not reveal any significant associations between the DPI and ABSI (OR: 0.70; 95% CI: 0.35-1.38; Ptrend = 0.30), BRI (OR: 0.80; 95% CI: 0.33-1.95; Ptrend = 0.59), and AVI (OR: 1.99; 95% CI: 0.92-4.33; Ptrend = 0.08).

CONCLUSIONS

Our study revealed no significant links between the DPI and foot ulcer indices, neuropathy measures, and anthropometric indices. These findings imply that factors beyond dietary phytochemical intake may exert greater influence on the development of foot ulcers in diabetes.

Association between two novel anthropometric measures and type 2 diabetes in a Chinese population

AIMS

To investigate the associations of conicity index (C-index) and relative fat mass (RFM) with incident type 2 diabetes mellitus (T2DM) among adults in China.

MATERIALS AND METHODS

A total of 10 813 participants aged over 18 years in Shenzhen Longhua district were enrolled in a follow-up study conducted from 2018 to 2022. The participants were categorized based on quartiles (Q) of C-index and RFM. The Cox proportional hazards model was performed to examine the relationships between C-index, RFM and the risk of T2DM.

RESULTS

After adjusting for potential confounding factors, including age, sex, occupation, marital status, education level, smoking status, alcohol consumption, physical exercise, hypertension status, fasting blood glucose (FBG) and total cholesterol (TC), both C-index and RFM showed positive and independent associations with risk of T2DM. The multivariable-adjusted hazard ratios (95% confidence intervals) for T2DM risk in participants in C-index Q3 and Q4 compared with those in C-index Q1 were 1.50 (1.12, 2.02) and 1.73 (1.29, 2.30), and 1.94 (1.44, 2.63), 3.18 (1.79, 5.64), 4.91 (2.68, 9.00) for participants in RFM Q2, Q3 and Q4 compared with RFM Q1. These differences were statistically significant (all p < 0.05).

CONCLUSION

C-index and RFM are strongly associated with new-onset T2DM and could be used to identify the risk of diabetes in large-scale epidemiological studies.

Wakabayashi & Daimon cardiometabolic index as an indicator to assess risk in adults. A systematic review

OBJECTIVE

To analyze the Wakabayashi & Daimon (2015) equation, as a predictive indicator of cardiometabolic diseases and its comparison with other indices.

DESIGN

A systematic review was carried out between January and March 2023, according to the PRISMA statement.

DATA SOURCE

Scopus, Web of Science, and PubMed databases were reviewed using "cardiometabolic index" (CMI) as the search term.

STUDY SELECTION

The following inclusion criteria were determined: studies in adults with cardiometabolic diseases using the Wakabayashi & Daimon (2015) CMI formula in different populations; studies that validate or compare the equation or that demonstrate the effects of the intervention.

DATA EXTRACTION

Of the 11 selected articles, the characteristics of the population, type of study, indicators for the validation of the CMI, the reported statistics and the conclusions that were recorded in a comparative table were obtained.

RESULTS AND CONCLUSIONS

Odds ratio, hazard ratio, sensitivity, and specificity were used to assess associations, risk, effectiveness, and validity of the tests, indicating favorable relationships between the factors analyzed and the results obtained. Validation and probabilistic analysis of the CMI were performed against diverse diseases such as obesity [Man >60y=AUC=0.90 (0.75-1.00) (p=0.01), Se=100, Sp=81.8, YI=0.82 and OR 4.66 and Women >60y=AUC=0.95 (0.88-1.00), p=0.001, Se=90.0, Sp=100, YI=0.90 and OR=36.27]; cardiovascular diseases [AUC=0.617, Se=0.675, Sp=0.509; HR=1.48 (1.33, 1.65), p=<0.001], among others. In conclusion CMI is a new utility index that broadly identifies the presence of risk that leads to cardiometabolic diseases in adults.

Association of adiposity indicators with cardiometabolic multimorbidity risk in hypertensive patients: a large cross-sectional study

Background

Cardiometabolic multimorbidity (CMM) has emerged as a prominent public health concern. Hypertensive patients are prone to develop comorbidities. Moreover, the accumulation of visceral adipose tissue is the main cause for the development of cardiometabolic diseases. The cardiometabolic index (CMI), lipid accumulation product (LAP), visceral adiposity index (VAI), and Chinese visceral adiposity index (CVAI) not only assess adipose tissue mass but also reflect adipose tissue dysfunction. So far, no study has been reported to evaluate the association of CMI, LAP, VAI, and CVAI with CMM risk in hypertensive patients. Therefore, this study aimed to assess the association between these adiposity indicators and the risk of CMM among Chinese hypertensive patients.

Methods

In this cross-sectional study, a total of 229,287 hypertensive patients aged 35 years and older were included from the National Basic Public Health Service Project. All participants underwent a face-to-face questionnaire survey, physical examination, and the collection of fasting venous blood samples. Multivariable logistic regression models were performed to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Receiver operating characteristic curve was utilized to evaluate the identification ability for CMM.

Results

After adjusting for confounders, each 1-standard deviation increase in CMI, LAP, VAI, and CVAI was associated with a 14%, 8%, 12%, and 54% increased risk of CMM, respectively. When comparing the highest quartile of these indicators with the lowest quartile, individuals in the highest quartile of CMM, LAP, VAI, and CVAI had a 1.39-fold (95% CI 1.30, 1.48), 1.28-fold (95% CI 1.19, 1.37), 1.37-fold (95% CI 1.29, 1.46), and 2.56-fold (95% CI 2.34, 2.79) increased risk of CMM after adjusting for potential confounders. Notably, a nonlinear association was observed for CMI, LAP, and VAI with the risk of CMM (all P nonlinearity < 0.001). CVAI exhibited the highest area under the receiver operating characteristic curve (AUC) among all the included adiposity indices in this analysis.

Conclusion

This study indicated the significant positive association of CMI, LAP, VAI, and CVAI with the risk of CMM in hypertensive patients. Among these indicators, CVAI demonstrated the most robust performance in predicting CMM risk and may serve as a valuable tool for identifying CMM risk in Chinese hypertensive patients.

Associations of trajectories in body roundness index with incident cardiovascular disease: a prospective cohort study in rural China

Aims

The body roundness index (BRI) has good predictive ability for both body fat and visceral adipose tissue. Longitudinal BRI trajectories can reveal the potential dynamic patterns of change over time. This prospective study assessed potential associations between BRI trajectories and incident cardiovascular disease (CVD) in rural regions of Northeast China.

Methods

In total, 13,209 participants (mean age: 49.0 ± 10.3 years, 6,856 [51.9%] male) were enrolled with three repeated times of BRI measurements at baseline (2004-2006), 2008, and 2010, and followed up until 2017 in this prospective study. Using latent mixture model, the BRI trajectories were determined based on the data from baseline, 2008 and 2010. Composite CVD events (myocardial infarction, stroke, and CVD death combined) was the primary endpoint. Cox proportional-hazards models were used to analyze the longitudinal associations between BRI trajectories and incident CVD.

Results

Three distinct BRI trajectories were identified: high-stable (n = 538), moderate-stable (n = 1,542), and low-stable (n = 11,129). In total, 1,382 CVD events were recorded during follow-up. After adjustment for confounders, the moderate-stable and high-stable BRI groups had a higher CVD risk than did the low-stable BRI group, and the HR (95%CI) were 1.346 (1.154, 1.571) and 1.751 (1.398, 2.194), respectively. Similar associations were observed between the trajectories of BRI and the risk of stroke and CVD death. The high-stable group was also significantly and independently associated with CVD, myocardial infarction, stroke, and CVD death in participants aged <50 years.

Conclusion

BRI trajectory was positively associated with incident CVD, providing a novel possibility for the primary prevention of CVD in rural regions of China.

The predictive significance of lipid accumulation products for future diabetes in a non-diabetic population from a gender perspective: an analysis using time-dependent receiver operating characteristics

Objective

The increasing prevalence of diabetes is strongly associated with visceral adipose tissue (VAT), and gender differences in VAT remarkably affect the risk of developing diabetes. This study aimed to assess the predictive significance of lipid accumulation products (LAP) for the future onset of diabetes from a gender perspective.

Methods

A total of 8,430 male and 7,034 female non-diabetic participants in the NAGALA (NAfld in the Gifu Area, Longitudinal Analysis) program were included. The ability of LAP to assess the risk of future new-onset diabetes in both genders was analyzed using multivariate Cox regression. Subgroup analysis was conducted to explore the impact of potential modifiers on the association between LAP and diabetes. Additionally, time-dependent receiver operator characteristics (ROC) curves were used to assess the predictive power of LAP in both genders for new-onset diabetes over the next 2-12 years.

Results

Over an average follow-up of 6.13 years (maximum 13.14 years), 373 participants developed diabetes. Multivariate Cox regression analysis showed a significant gender difference in the association between LAP and future diabetes risk (P-interaction<0.05): the risk of diabetes associated with LAP was greater in females than males [hazard ratios (HRs) per standard deviation (SD) increase: male 1.20 (1.10, 1.30) vs female 1.35 (1.11, 1.64)]. Subgroup analysis revealed no significant modifying effect of factors such as age, body mass index (BMI), smoking history, drinking history, exercise habits, and fatty liver on the risk of diabetes associated with LAP (All P-interaction <0.05). Time-dependent ROC analysis showed that LAP had greater accuracy in predicting diabetes events occurring within the next 2-12 years in females than males with more consistent predictive thresholds in females.

Conclusions

This study highlighted a significant gender difference in the association between LAP and future diabetes risk. The risk of diabetes associated with LAP was greater in females than in males. Furthermore, LAP showed superior predictive ability for diabetes at different time points in the future in females and had more consistent and stable predictive thresholds in females, particularly in the medium and long term.

The nonlinear correlation between the cardiometabolic index and the risk of diabetes: A retrospective Japanese cohort study

BACKGROUND

The cardiometabolic index (CMI) has been proposed as a novel indicator of cardiometabolic status. However, evidence on the relationship between CMI and diabetes mellitus (DM) risk was limited. Our study aimed to explore the relationship between CMI and DM risk among a large cohort of Japanese adults.

METHODS

This retrospective cohort study recruited 15453 Japanese adults without diabetes at baseline who underwent physical examinations at the Murakami Memorial Hospital between 2004 and 2015. Cox proportional-hazards regression was applied to evaluate the independent relationship between CMI and diabetes. Our study performed a generalized smooth curve fitting (penalized spline technique) and an additive model (GAM) to determine the non-linear relationship between CMI and DM risk. In addition, a set of sensitivity analyses and subgroup analyses were employed to evaluate the relationship between CMI and incident DM.

RESULTS

After adjusting for confounding covariates, CMI was positively related to the DM risk in Japanese adults (HR: 1.65, 95%CI: 1.43-1.90, P<0.0001). A series of sensitivity analyses were also employed in this study to guarantee the reliability of the findings. In addition, our study discovered a non-linear association between CMI and diabetes risk. CMI's inflection point was 1.01. A strong positive association between CMI and diabetes incidence was also discovered to the left of the inflection point (HR: 2.96, 95%CI: 1.96-4.46, P<<0.0001). However, their association was not significant when CMI was higher than 1.01 (HR: 1.27, 95%CI: 0.98-1.64, P=0.0702). Interaction analysis showed that gender, BMI, habit of exercise, and smoking status interacted with CMI.

CONCLUSION

Increased CMI level at baseline is associated with incident DM. The association between CMI and incident DM is also non-linear. A high CMI level is associated with an increased risk for DM when CMI is below 1.01.

Association of lipid accumulation product with type 2 diabetes mellitus, hypertension, and mortality: a systematic review and meta-analysis

Purpose

Novel anthropometric measures are simple, applicable, and inexpensive tools for cardiovascular risk assessment. This study evaluates the association of lipid accumulation product (LAP) with hypertension, type 2 diabetes mellitus (T2DM), and all-cause mortality, and compares it with other anthropometric measures.

Methods

PubMed, Web of Science, EMBASE, and Scopus were systematically searched for articles published until May 15, 2021. We included all the studies that had measured LAP predictability for T2DM, all-cause mortality, and hypertension with no limitation in comorbidities and follow-up duration. We assessed the predictability measures of LAP for the aforementioned outcomes. We also performed a meta-analysis on four articles on mortality using an inverse variance method by the "meta" package in R software.

Results

Twenty-nine studies were included in the review after applying the eligibility criteria. The hazard ratio for all-cause mortality per one standard deviation increment of LAP was 1.24 (95% confidence interval [CI]: 1.00-1.53; P = 0.0463) in females, and 1.07 (95% CI: 0.74-1.57; P = 0.709) in males. All included studies found a direct association between LAP with T2DM and hypertension. However, studies used different cut-off points for LAP. Most studies found that LAP was superior in predicting T2DM and hypertension compared to conventional indices, e.g., body mass index and waist circumference. We found that LAP may have higher prognostic significance in females compared to males.

Conclusion

LAP is an inexpensive method to evaluate the risk of all-cause mortality, T2DM, and hypertension, and could outperform conventional anthropometric indices in this regard.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40200-022-01114-z.

Evaluation of novel obesity- and lipid-related indices as predictors of abnormal glucose tolerance in Chinese women with polycystic ovary syndrome

PURPOSE

We aimed to evaluate the performance of Chinese visceral adiposity index (CVAI), visceral adiposity index (VAI), lipid accumulation product (LAP), triglyceride glucose (TyG) as indices in screening abnormal glucose tolerance (AGT) in Chinese women with polycystic ovary syndrome (PCOS), using the oral glucose tolerance test (OGTT) as a reference test. In addition, we essentially compared the abilities of these indices with body mass index (BMI), waist circumference (WC), fasting plasma glucose (FPG).

MATERIALS AND METHODS

All 1113 PCOS patients evaluated in this study underwent OGTTs. The 2-h post-oral glucose load (2 h-PG) level was used to categorize subjects into two groups: those having AGT or normal glucose tolerance (NGT) levels.

RESULTS

A statistically significant positive correlation between levels of 2 h-PG and FPG, BMI, WC, LAP, VAI, CVAI, TyG, (P < 0.05), was observed. The strongest correlation was found between the levels of 2 h-PG and CVAI (r = 0.47). The CVAI provided the highest area under the receiver-operating characteristic curve (AUC) for AGT, followed by LAP, BMI, TyG, VAI, WC, and FPG. The CVAI of 32.61 (with AUC: 0.76, sensitivity: 73%, specificity: 70%, positive preductive value (PPV): 0.41, negative predictive value (NPV): 0.90) was found to be the cut-off point for AGT in Chinese women with PCOS.

CONCLUSIONS

CVAI may not reliably detect AGT in Chinese women with PCOS. However, it is suitable as a first screening indicator to guide physicians to ordering OGTT.

Transition of cardiometabolic status and the risk of type 2 diabetes mellitus among middle-aged and older Chinese: A national cohort study

AIMS/INTRODUCTION

The cardiometabolic index (CMI) has been proposed as a novel indicator of cardiometabolic status. This study aimed to investigate the effects of CMI and its longitudinal transitions on the development of type 2 diabetes mellitus in middle-aged and older Chinese.

MATERIALS AND METHODS

We used data from the China Health and Retirement Longitudinal Study (2011-2018). CMI was calculated as the product of the waist circumference to height ratio and the triglyceride to high-density lipoprotein cholesterol ratio. At baseline in 2011, the subjects were classified into low- and high-CMI groups, and then divided into four transition patterns during follow-up, i.e. maintained-low, low-to-high, high-to-low, and maintained-high CMI. The hazard ratios (HRs) of different transition patterns for type 2 diabetes mellitus were calculated using multivariable Cox frailty models.

RESULTS

During 2011-2018, 7,347 participants were included. Participants with a high-CMI at baseline had a significantly higher risk of new-onset type 2 diabetes mellitus than those with a low-CMI (HR = 1.78, 95% CI:1.55-2.05). For subjects with a low-CMI at baseline, the risk of developing type 2 diabetes mellitus increased by 75% if their CMI status changed to high during follow-up (HRlow-to-high  = 1.75, 95% CI:1.35-2.28). Meanwhile, for subjects with a maintained-high CMI, no significant risk reduction for type 2 diabetes mellitus was found when their CMI changed to low status (HRhigh-to-low  = 0.77, 95% CI: 0.58-1.01).

CONCLUSIONS

Baseline CMI levels and longitudinal CMI transition patterns were associated with a higher risk of type 2 diabetes mellitus. Early anti-lipid measures should be taken to prevent type 2 diabetes mellitus in middle-aged and older Chinese.

Abdominal volume index trajectories and risk of diabetes mellitus: Results from the China Health and Nutrition Survey

AIMS/INTRODUCTION

Abdominal obesity is a risk factor for developing diabetes mellitus, but trajectories of abdominal obesity over time and incident diabetes mellitus have not been considered. We derived trajectories of abdominal volume index (AVI) over 16 years of follow up, and examined the associations between AVI trajectories and risk of diabetes mellitus.

MATERIALS AND METHODS

Data were used from the China Health and Nutrition Survey, and 5,267 participants were enrolled to fit the trajectory of AVI by using latent class growth models. Multivariate logistic regression models explored the relationship between different AVI trajectories and risk of diabetes mellitus. In addition, we examined the slope of the AVI trajectories in relation to age to identify appropriate life course intervention opportunities for the prevention of diabetes mellitus.

RESULTS

Three trajectories were derived reflecting graded categories in the speed and slope of increase in AVI over time: slow, intermediate and fast increase group, respectively. After multivariate adjustment, the odds ratios for diabetes mellitus among those in the intermediate and fast increase groups were 1.81 (95% confidence interval 1.37-2.38, P < 0.001) and 2.80 (95% confidence interval 1.85-4.24, P < 0.001) respectively, relative to the slow increase group. The distribution of AVI slope in the slow increase group showed an inverted "U" shape, whereas the fast increase group presented a "U" shape.

CONCLUSIONS

AVI trajectory is associated with an increased risk of diabetes mellitus. These results provide new insights on the relationship between abdominal adiposity and diabetes mellitus, which in turn can help improve clinical and public health intervention for diabetes mellitus prevention.

Trajectories of metabolic risk factors during the development of type 2 diabetes in Chinese adults

AIMS

China has the largest number of adults with diabetes. Although multiple metabolic risk factors (MRFs) are implicated in the development of diabetes, it remains unclear how they progress during the development of diabetes among Chinese. We examined trajectories of multiple MRFs among Chinese and identified the critical period when drastic changes occurred during the development of diabetes.

METHODS

This prospective cohort study included participants since 2006-2007 in the Kailuan study. People attended biennial examinations until 2017 with additions of new participants at each examination cycle. The time when a participant first completed the examination was designated as the baseline. A total of 122,659 participants without prevalent diabetes at baseline and with complete follow-up data were included. MRFs were collected via biennial physical examinations and laboratory measures. Incident diabetes cases were identified via biennial fasting glucose tests and self-reported physician-diagnosis.

RESULTS

During up to 12 years of follow-up, 14,922 incident diabetes cases were identified. Compared with participants who did not develop diabetes, those who developed diabetes had more adverse levels of most MRFs at baseline and during follow-up. Abrupt increases in multiple MRFs (including fasting glucose, surrogate insulin resistance indicators, lipids, systolic blood pressure, pulse pressure, heart rate, alanine aminotransferase, and C-reactive protein) were observed 3 years before the diagnosis of diabetes.

CONCLUSIONS

We identified 3 years before diabetes diagnosis as a critical period when multiple MRFs displayed drastic changes. This would have implications for early monitoring and timely prevention for individuals who experience sudden adverse progression of multiple MRFs.

Non-linear relationship between the body roundness index and incident type 2 diabetes in Japan: a secondary retrospective analysis

Background

Body roundness index (BRI) is one of the obesity-related anthropometric indices. However, studies on the relationship between BRI and diabetes risk is limited. The purpose of this study was to explore the relationship between baseline BRI and incident type 2 diabetes mellitus (T2DM) in the Japanese population.

Methods

A retrospective longitudinal study of 15,310 participants in a physical examination program at Murakami Memorial Hospital in Japan from 2004 to 2015. The association between BRI levels and incident T2DM was analyzed by Cox proportional-hazards regression, smooth curve fitting, subgroup analyses, and a set of sensitivity analyses. Receiver operating characteristic curve analysis was used to assess the ability of BRI to predict diabetes.

Result

Baseline BRI levels were elevated in participants who developed T2DM. Baseline BRI levels were positively associated with incident T2DM after adjusting confounding variables (HR = 1.570, 95% CI 1.360–1.811). Additionally, we did a set of sensitivity analyses to ensure the robustness of the results. There was also a non-linear relationship between BRI and incident diabetes in both genders, and the inflection point of BRI was 4.137 in females and 3.146 in males. We found a strong positive correlation between BRI and the incidence of diabetes on the right of the inflection point (Male: HR = 1.827, 95% CI 1.449–2.303; Female: HR = 4.189, 95% CI 1.862–9.421). What’s more, among the anthropometric indices, BRI showed the optimal capability to predict T2DM (Male: AUC = 0.706, 95% CI 0.674–0.738; Female: AUC = 0.735, 95% CI 0.676–0.795).

Conclusion

An elevated BRI level in baseline was independently associated with incident T2DM. Baseline BRI improves the identification of patients at risk of T2DM and may enable early and optimized therapy to improve their outcomes.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12967-022-03321-x.

Association between metabolic scores for visceral fat and chronic kidney disease: A cross-sectional study

INTRODUCTION

Central obesity is closely linked to the risk of chronic kidney disease (CKD). This study aimed to evaluate the association between the novel central obesity index- metabolic score for visceral fat (METS-VF) and the risk of CKD in a Chinese population, and to compare its ability to predict CKD with other central obesity indices including waist circumference (WC), waist-to-height ratio (WHtR), lipid accumulation product (LAP), visceral adiposity index (VAI), a body shape index (ABSI), body roundness index (BRI), and cardiometabolic index (CMI).

METHODS

This cross-sectional study included 8866 individuals from China. Demographic information, lifestyle data, and medical history data were collected, and physical examinations, anthropometric measurements and laboratory tests were performed for each participant. CKD was defined as an estimated GFR< 60 ml/min/1.73m². Multivariate logistic regression models were used to evaluate the association between the METS-VF and the prevalence of CKD. Receiver operating characteristic (ROC) analyses were performed to assess and compare the predictive abilities of the central obesity indices and determine the optimal cut-off points.

RESULTS

A graded increase in the prevalence of CKD was observed with increasing METS-VF tertiles. Moreover, the METS-VF was independently associated with the risk of CKD after adjustment for current smoking, current drinking, physical activity level, diabetes, hypertension, CVD history and BMI. Compared with participants with a METS-VF in the lowest tertile, the multivariate-adjusted ORs and 95% CIs for participants with a METS-VF in the highest tertile were 3.943 (2.435-6.385) in the overall population, 3.585 (1.585-8.109) for men and 4.627 (2.485-8.616) for women. Significant interactions were found between the METS-VF and the risk of CKD by age (P value for interaction = 0.023). In ROC analysis, the METS-VF had a higher AUC value than other indices for predicting CKD in men and had comparable or higher AUC than other indices for women. For predicting CKD, the optimal cut-off value of the METS-VF was 6.891 for men and 6.744 for women. The METS-VF yielded the greatest Youden index among all indices for both sexes.

CONCLUSION

A higher METS-VF was independently associated with a greater risk of CKD. The METS-VF can be a useful clinical indicator for identifying CKD, as it had superior predictive power for CKD when compared with other central obesity indices.

Association Between Lipid Accumulation Product and Target Organ Damage in Elderly Population: The Northern Shanghai Study

Introduction

Lipid accumulation product (LAP), calculated from waist circumference (WC) and triglycerides (TG), is a novel index that correlates cardiovascular disease. We aimed to investigate the relationship between LAP and target organ damage (TOD) in elderly Chinese community-dwelling individuals.

Materials and Methods

We enrolled 3363 participants whose age was ≥65 years old. TOD, including left ventricular hypertrophy (LVH), arterial stiffness (AS), lower extremity atherosclerotic (LEA), micro-albuminuria (MAU) and chronic kidney disease (CKD), was measured using standard methods. LAP was calculated as (WC–65) × TG in men and (WC–58) × TG in women. Both quartiles and continuation of LAP were analyzed.

Results

Age-sex adjusted partial correlation analysis showed that LAP was significantly associated with CVD risk factors. With the first quartile (Q1) as a reference, in univariate logistic regression, the fourth quartile (Q4) of LAP was associated with all TOD. In multivariate model, Q4 of LAP was only associated with an increased risk of AS (odds ratio (OR) = 1.88, 95% confidence interval (CI): 1.37–2.58, P_{for trend}< 0.001), MAU (OR = 1.33, 95% CI: 1.01–1.75, P_{for trend}= 0.02) and CKD (OR = 2.39, 95% CI: 1.39–4.12, P_{for trend}< 0.001). But, Q4 of LAP was not associated with an increased risk of LVH (OR = 1.19, 95% CI: 0.85–1.65, P_{for trend}= 0.25) or LEA (OR = 0.87, 95% CI: 0.58–1.29, P_{for trend}= 0.96). Similar associations were found when analyzed continuously.

Conclusion

The novel metabolic parameter LAP is significantly and independently associated with an increased risk of arterial stiffness, chronic kidney disease and micro-albuminuria in Chinese community-dwelling elderly individuals.

Anthropometric Indicators as a Tool for Diagnosis of Obesity and Other Health Risk Factors: A Literature Review

Obesity is characterized by the accumulation of an excessive amount of fat mass (FM) in the adipose tissue, subcutaneous, or inside certain organs. The risk does not lie so much in the amount of fat accumulated as in its distribution. Abdominal obesity (central or visceral) is an important risk factor for cardiovascular diseases, diabetes, and cancer, having an important role in the so-called metabolic syndrome. Therefore, it is necessary to prevent, detect, and appropriately treat obesity. The diagnosis is based on anthropometric indices that have been associated with adiposity and its distribution. Indices themselves, or a combination of some of them, conform to a big picture with different values to establish risk. Anthropometric indices can be used for risk identification, intervention, or impact evaluation on nutritional status or health; therefore, they will be called anthropometric health indicators (AHIs). We have found 17 AHIs that can be obtained or estimated from 3D human shapes, being a noninvasive alternative compared to X-ray-based systems, and more accessible than high-cost equipment. A literature review has been conducted to analyze the following information for each indicator: definition; main calculation or obtaining methods used; health aspects associated with the indicator (among others, obesity, metabolic syndrome, or diabetes); criteria to classify the population by means of percentiles or cutoff points, and based on variables such as sex, age, ethnicity, or geographic area, and limitations.

Triglyceride-glucose index as predictor for future type 2 diabetes mellitus in a Chinese population in southwest China: a 15-year prospective study

PURPOSE

Triglyceride-glucose (TyG) index is an emerging surrogate predictor of incident type 2 diabetes mellitus (T2DM). The study aimed to examine the association between TyG index and incident T2DM in a prospective Chinese cohort.

METHODS

The data were collected in 1992 and recollected in 2007 from the same group of 687 participants. The association between TyG index and T2DM was analysed.

RESULTS

During follow-up, 74 participants developed T2DM and the risk of T2DM increased with TyG index. The adjusted hazard ratio (HR) was 3.36 (95% CI: 1.52-7.39, P < 0.001) comparing the top TyG quartile to the bottom quartile. Smooth curve fitting revealed a nonlinear association and threshold effect between TyG index and incident T2DM with a nadir of risk when TyG index was around 8.51. For TyG ≤ 8.51, the risk of incident T2DM tended to decrease with per SD increase in TyG but no statistical significance was achieved (adjusted HR: 0.69, 95% CI: 0.43-1.12, P = 0.133). For TyG > 8.51, the risk of incident T2DM significantly increased by 38% with per SD increase in TyG (adjusted HR: 1.38, 95% CI: 1.14-1.67, P = 0.001). Time-dependent receiver operating curve suggested helpful discriminative power of TyG index for T2DM. It also significantly promoted the reclassification ability beyond the baseline risk model with net reclassification index of 0.159 (P = 0.020). Sensitivity analysis excluding participants with prediabetes demonstrated similar results.

CONCLUSIONS

The TyG index was a significant and independent predictor for future T2DM development. The shape of relationship will require further studies.

Relationship between Body Roundness Index and Risk of Type 2 Diabetes in Japanese Men and Women: A Reanalysis of a Cohort Study

PURPOSE

The purpose of this study was to investigate the association between body roundness index (BRI) and type 2 diabetes (T2DM) in each sex, explore the dose-response relationship between them, and evaluate the predictive value of BRI for T2DM.

MATERIALS AND METHODS

A retrospective cohort study was performed on 15,464 Japanese patients at the Murakami Memorial Hospital. Data on anthropometric indices and biochemical parameters were obtained. Multivariate Cox regression models were used to estimate the hazard ratios (HRs) of incident T2DM associated with BRI. Dose-response relationships were evaluated using a smoothing function analysis and the threshold effect. Receiver operating characteristic curves were used to evaluate and compare the predictive values of BRI, body mass index (BMI), and waist circumference (WC) for T2DM.

RESULTS

During a median 5.4-year follow-up period, 373 subjects were diagnosed with T2DM. After adjusting for age, alcohol intake, smoking status, fatty liver, systolic blood pressure, fasting plasma glucose, glycated hemoglobin, high-density lipoprotein cholesterol, triglycerides, and total cholesterol, the relationship between BRI and T2DM was linear in women (HR (95% CI) for BRI Z score = 1.48 (1.26,1.74)) and curvilinear in men (HR (95% CI) on the left and right of the inflection point = 0.70 (0.44, 1.10) and 1.46 (1.27, 1.67), respectively). Compared with BMI (area under the curve (AUC) = 0.684; p < 0.001) and WC (AUC = 0.700; p=0.007), BRI was the strongest predictor of T2DM in men (AUC = 0.715). Similarly, the AUC of BRI was larger than that of BMI (AUC = 0.757; p=0.966) and WC (AUC = 0.733; p=0.015) in women.

CONCLUSIONS

BRI was positively linearly associated with an elevated risk of incident T2DM in women. In men, the relationship between BRI and T2DM was J-shaped. BRI is an effective indicator of predicting T2DM. Its discriminatory power was higher than that of BMI and WC in both sexes.

Cut-off points of anthropometric markers associated with hypertension and diabetes in Peru: Demographic and Health Survey 2018

OBJECTIVE

To determine the optimal anthropometric cut-off points for predicting the likelihood ratios of hypertension and diabetes in the Peruvian population.

DESIGN

A cross-sectional study was performed to establish cut-off values for body mass index (BMI), waist circumference (WC), waist:height ratio (WHtR) and Conicity index (C-index) associated with increased risk of hypertension and diabetes. Youden's index (YIndex), area under the curve (AUC), sensitivity and specificity were calculated.

SETTING

Peruvian households.

PARTICIPANTS

Peruvian population over the age of 18 years.

RESULTS

A total of 31 553 subjects were included, 57 % being women. Among the women, 53·06 % belonged to the 25- to 44-year-old age group [mean age: 41·66 in men and 40·02 in women]. The mean BMI, WHtR and C-index values were higher in women 27·49, 0·61, 1·30, respectively, while the mean WC value was higher in men 92·12 cm (sd ± 11·28). The best predictors of hypertension in men were the WHtR (AUC = 0·64) and the C-index (AUC = 0·64) with an optimal cut-off point of 0·57 (YIndex = 0·284) and 1·301 (YIndex = 0·284), respectively. Women showed an AUC of 0·63 and 0·61 in the WHtR and C-index, respectively, with an optimal cut-off of 0·61 (YIndex = 0·236) and 1·323 (YIndex = 0·225). The best predictor for diabetes was the C-index: with an AUC = 0·67 and an optimal cut-off of 1·337 (YIndex = 0·346) for men and an AUC = 0·66 and optimal cut-off of 1·313 (YIndex = 0·319) for women.

CONCLUSIONS

Our findings show that in Peruvian adults, the WHtR and the C-index have the strongest association with hypertension in both sexes. Likewise, the C-index had the strongest association with diabetes.

Effectiveness of body roundness index in predicting metabolic syndrome: A systematic review and meta-analysis

Body roundness index (BRI) is a new anthropometric index developed to predict both body fat and the percentage of visceral adipose tissue. Our aim was to investigate whether BRI is superior to traditional anthropometric indices in predicting metabolic syndrome (MetS). This systematic review and meta-analysis was conducted using Pubmed, Scopus and Web of Sciences databases. The estimated pooled areas under curve (AUCs) for BRI predicting MetS was higher than body mass index (BMI), waist-to-hip ratio (WHR), body shape index (ABSI) and body adiposity index (BAI), similar to waist circumference (WC) and lower than waist-to-height ratio (WHtR). However, the difference between BRI and BMI, WC and WHtR predicting MetS was statistically non-significant. Similar results were found with the summary receiver operating characteristic curve (AUC-SROC). In addition, the non-Chinese population had pooled AUCs greater than the Chinese population for all indices. Pooled ORs showed that BRI is associated with an increased MetS risk. In conclusion, BRI had good discriminatory power for MetS in adults of both sexes from diverse populations (AUC > 0.7; AUC-SROC>0.7). However, WC and WHtR offer the best performance when screening for MetS, and non-significant differences were found with BRI. In contrast, BRI was superior to BMI, WHR, ABSI and BAI in predicting MetS.