美国成年人的心脏代谢指数与胰岛素抵抗、糖尿病前期和糖尿病的关系:一项横断面研究。

IF 2.8 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM BMC Endocrine Disorders Pub Date : 2024-10-15 DOI:10.1186/s12902-024-01676-4
An-Bang Liu, Yan-Xia Lin, Ting-Ting Meng, Peng Tian, Jian-Lin Chen, Xin-He Zhang, Wei-Hong Xu, Yu Zhang, Dan Zhang, Yan Zheng, Guo-Hai Su
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引用次数: 0

摘要

背景:心脏代谢指数(CMI)是评估心脏代谢健康和 2 型糖尿病(DM)的新指标,但其与胰岛素抵抗(IR)和糖尿病前期(preDM)的关系尚未得到充分研究。对 CMI 与这些疾病之间的非线性关系的理解也存在空白。我们的研究旨在阐明这些关联:我们从 2007-2020 年美国国家健康与营养调查(NHANES)中纳入了 13142 名成年人。CMI通过甘油三酯-高密度脂蛋白胆固醇(TG/HDL-C)乘以腰围-身高比(WHtR)计算得出。利用加权多变量线性回归和逻辑回归探讨了 CMI 与糖代谢指标、IR、preDM 和 DM 的关系。使用广义加法模型(GAM)、平滑曲线拟合和双片式逻辑回归评估了非线性关联:多变量回归显示,CMI 与葡萄糖代谢生物标记物之间存在正相关,包括 FBG(β = 0.08,95% CI:0.06-0.10)、HbA1c(β = 0.26,95% CI:0.22-0.31)、FSI(β = 4.88,95% CI:4.23-5.54)和 HOMA-IR (β = 1.85,95% CI:1.56-2.14)。CMI与IR(OR = 3.51,95% CI:2.94-4.20)、preDM(OR = 1.49,95% CI:1.29-1.71)和DM(OR = 2.22,95% CI:2.00-2.47)风险增加之间也存在明显的相关性。在 CMI 与 IR、preDM 和 DM 之间发现了反向非线性 L 型关系,饱和拐点分别为 1.1、1.45 和 1.6。在这些临界点以下,CMI 的增加与 IR、preDM 和 DM 风险的增加显著相关:结论:CMI 与 IR、preDM 和 DM 呈反向 L 型非线性关系,这表明将 CMI 降低到一定水平可有效预防这些疾病。
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Associations of the cardiometabolic index with insulin resistance, prediabetes, and diabetes in U.S. adults: a cross-sectional study.

Background: The cardiometabolic index (CMI) is a novel metric for assessing cardiometabolic health and type 2 diabetes mellitus (DM), yet its relationship with insulin resistance (IR) and prediabetes (preDM) is not well-studied. There is also a gap in understanding the nonlinear associations between CMI and these conditions. Our study aimed to elucidate these associations.

Methods: We included 13,142 adults from the National Health and Nutrition Examination Survey (NHANES) 2007-2020. CMI was calculated by multiplying the triglyceride-to-high density lipoprotein cholesterol (TG/HDL-C) by waist-to-height ratio (WHtR). Using weighted multivariable linear and logistic regression explored the relationships of CMI with glucose metabolism markers, IR, preDM, and DM. Nonlinear associations were assessed using generalized additive models (GAM), smooth curve fittings, and two-piecewise logistic regression.

Results: Multivariate regression revealed positive correlations between CMI and glucose metabolic biomarkers, including FBG (β = 0.08, 95% CI: 0.06-0.10), HbA1c (β = 0.26, 95% CI: 0.22-0.31), FSI (β = 4.88, 95% CI: 4.23-5.54), and HOMA-IR (β = 1.85, 95% CI: 1.56-2.14). There were also significant correlations between CMI and increased risk of IR (OR = 3.51, 95% CI: 2.94-4.20), preDM (OR = 1.49, 95% CI: 1.29-1.71), and DM (OR = 2.22, 95% CI: 2.00-2.47). Inverse nonlinear L-shaped associations were found between CMI and IR, preDM, and DM, with saturation inflection points at 1.1, 1.45, and 1.6, respectively. Below these thresholds, increments in CMI significantly correlated with heightened risks of IR, preDM, and DM.

Conclusions: CMI exhibited inverse L-shaped nonlinear relationships with IR, preDM, and DM, suggesting that reducing CMI to a certain level might significantly prevent these conditions.

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来源期刊
BMC Endocrine Disorders
BMC Endocrine Disorders ENDOCRINOLOGY & METABOLISM-
CiteScore
4.40
自引率
0.00%
发文量
280
审稿时长
>12 weeks
期刊介绍: BMC Endocrine Disorders is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of endocrine disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
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