RESULTS: MEDLINE via PubMed and Embase databases were searched for relevant articles up to December 14, 2021. Random-effects generalized least squares regression models were used to assess the quantitative association between VAI and T2DM risk across studies. Restricted cubic splines were used to model the dose-response association. A total of 9 prospective cohort studies and 5 cross sectional studies were included in our review. Based on the meta-analysis, the pooled RR of T2DM was 2.05 (95% CI 1.74-2.41) for the highest versus reference VAI category. We found that the risk of T2DM was increased by 44% (RR, 1.44; 95% CI, 1.23-1.68) with each 1-unit increment of VAI. While, we found no evidence of a nonlinear dose-response association of VAI and T2DM (Pnon-linearity = 0.428). With the linear cubic spline model, when compared to population with VAI at 0.6, for those with VAI at 2.0, the risk of T2DM was increased by 81% (RR, 1.81; 95% CI 1.55-2.12).
CONCLUSIONS: Our meta-analysis provides quantitative data suggesting that VAI is associated with an increased risk of T2DM. Public health strategies focusing on weight loss among obesity, especially the people characterized by the thin-on-the-outside--fat-on-the-inside phenotype could possibly reduce a substantial risk of T2DM.
BACKGROUND: PROSPERO CRD42022372666.
结果:截至2021年12月14日,通过PubMed和Embase数据库搜索了MEDLINE的相关文章。随机效应广义最小二乘回归模型用于评估研究中VAI与T2DM风险之间的定量关联。使用受限的三次样条对剂量-反应关联进行建模。共有9项前瞻性队列研究和5项横断面研究纳入我们的综述。根据荟萃分析,与参考VAI类别相比,T2DM合并RR最高为2.05(95%CI1.74-2.41).我们发现T2DM的风险增加了44%(RR,1.44;95%CI,1.23-1.68),每增加1个单位的VAI。同时,我们没有发现VAI和T2DM存在非线性剂量-反应相关性的证据(P非线性=0.428).使用线性三次样条模型,与VAI为0.6的人群相比,VAI为2.0的人群,T2DM的风险增加了81%(RR,1.81;95%CI1.55-2.12)。
结论:我们的荟萃分析提供了定量数据,表明VAI与T2DM风险增加相关。关注肥胖人群减肥的公共卫生策略,尤其是以外薄-内脂表型为特征的人群可能会降低T2DM的实质性风险.
背景:PROSPEROCRD42022372666。