内脏脂肪指数与中国中老年糖尿病前期人群血糖变化关联的队列研究

Association between visceral adiposity index and blood glucose variation in Chinese middle-aged and elderly prediabetic population:a cohort study

目的通过队列研究设计探讨内脏脂肪指数(visceral adiposity index,VAI)与糖尿病前期人群血糖变化的相关性。方法基于中国健康与养老追踪调查(CHARLS),选择纳入2011年参加基线调查和2015年参与随访的中老年糖尿病前期人群为研究对象。采用多分类logistic回归模型分析VAI与糖尿病前期人群发展为糖尿病或恢复为正常血糖的关联性。结果随访期间309例(14.29%)发展为糖尿病,1369人(63.29%)仍然保持糖尿病前期,485人(22.42%)恢复为正常血糖。在调整了协变量后多分类logistic回归结果显示:VAI每增加1个标准差,进展为糖尿病的风险就上升6%;与Q4(2.76~35.31)组相比,Q1(0.03~0.93)、Q2(0.94~1.54)、Q3(1.55~2.75)组均会降低糖尿病发生风险,其OR及95%CI分别为(0.51,95%CI:0.35~0.74)、(0.53,95%CI:0.37~0.75)、(0.69,95%CI:0.49~0.97);仅Q1(0.03~0.93)组会增加恢复为正常血糖的概率(OR=1.43,95%CI:1.04~1.95)。结论VAI与糖尿病前期进展密切相关,仅低VAI会增加恢复为正常血糖的概率。

Objective To investigate the association between visceral adiposity index(VAI)and blood glucose variation in the prediabetic population through a cohort study.Methods Based on the China Health and Retirement Longitudinal Study(CHARLS),middle-aged and elderly Prediabetic people who participated in the baseline survey in 2011 and follow-up in 2015 were included.The association between VAI and the development to diabetes or the return to normoglycemia in the prediabetic population was analyzed by multiple logistic regression model.Results During follow-up,309(14.29%)developed to diabetes,1369(63.29%)remained prediabetes,and 485(22.42%)returned to normoglycemia.After adjusting for covariates,multiple logistic regression showed that the risk of development to diabetes increased by 6%for every standard deviation increase in VAI;compared with Q4(2.76-35.31)group,Q1(0.03-0.93),Q2(0.94-1.54),and Q3(1.55-2.75)groups all reduced the risk of diabetes,and the values of OR and 95%CI were(0.51,95%CI:0.35-0.74),(0.53,95%CI:0.37-0.75),and(0.69,95%CI:0.49-0.97),respectively;only the Q1(0.03-0.93)group increased the probability of returning to normoglycemia(OR=1.43,95%CI:1.04-1.95).Conclusions VAI is strongly associated with the development of prediabetes,only low VAI increases the probability of returning to normoglycemia.