背景:体重调整腰围指数(WWI)是一种定量的人体测量指数,可用于评估肥胖。这项研究调查了美国成年人(US)居民患2型糖尿病(T2DM)的风险与WWI之间的关系。
方法:NHANES(国家健康和营养检查调查)2001-2018为这项调查提供了数据。本研究采用多因素Logistic回归分析,平滑曲线拟合,亚组分析,和相互作用测试,以评估WWI和T2DM之间的关联。此外,使用两阶段线性回归模型计算阈值效应.受试者工作特征(ROC)曲线评估了WWI和常用肥胖指标的诊断能力。
结果:20,477名参与者被纳入分析,WWI水平较高的患者2型糖尿病患病率较高.WWI和T2DM具有非线性关系,与断点左侧的正相关(WWI=12.35)(OR=1.82,95CI:1.64-2.02),然而,在右边,未发现这种关系(OR=0.9,95CI:0.61-1.34)。对于第一次世界大战中的每一个单位上升,在控制所有其他变量后,患T2DM的概率增加了67%(OR:1.67,95CI:1.53-1.83).根据亚组分析,40岁以下个体WWI与T2DM的相关性较高(P<0.001)。ROC分析表明,与其他肥胖指标相比,WWI在预测T2DM方面具有最佳的辨别力和准确性(WC,BMI,和重量)。
结论:在美国个体中,较高的WWI值具有较高的T2DM患病率,尤其是40岁以下的成年人。WWI预测T2DM的能力最强。因此,应强调WWI在美国成年人T2DM早期识别中的重要性.
BACKGROUND: The weight-adjusted waist index (WWI) is a quantitative anthropometric index that can be applied to evaluate obesity. This study examined the relationship between adult United States (US) residents\' risk of diabetes mellitus type 2 (T2DM) and WWI.
METHODS: The NHANES (National Health and Nutrition Examination Survey) 2001-2018 provided the data for this investigation. This study used multifactorial logistic regression analysis, smoothed curve fitting, subgroup analysis, and interaction tests to assess the association between WWI and T2DM. Additionally, threshold effects were calculated using a two-stage linear regression model. The receiver operating characteristic(ROC) curves evaluated the diagnostic ability of the WWI and commonly used obesity indicators.
RESULTS: 20,477 participants were enrolled in the analysis, and patients with greater levels of WWI had a higher prevalence of T2DM. WWI and T2DM have a non-linear relationship, with a positive association found on the left side of the breakpoint (WWI = 12.35) (OR = 1.82, 95%CI:1.64-2.02), whereas, on the right side, no such relationship was found (OR = 0.9, 95%CI:0.61-1.34). For every unit rise in WWI, the probability of having T2DM increased by 67% after controlling for all other variables (OR:1.67,95%CI:1.53-1.83). Based on subgroup analyses, individuals under 40 had a higher correlation between WWI and T2DM (P < 0.001).ROC analyses showed that WWI had the best discrimination and accuracy in predicting T2DM compared to other obesity indicators (WC, BMI, and Weight).
CONCLUSIONS: Higher WWI values had a higher prevalence of T2DM in US individuals, especially in adults under 40. WWI has the strongest ability to predict T2DM. Therefore, the importance of WWI in the early identification of T2DM in US adults should be emphasized.