Four-year changes in central fatness, risk of diabetes, and metabolic control in older adults: a cohort study with mediation analysis

Cai, Xue1,2; Luo, Dan2; Liu, Shuling2; Li, Ruxue2; Lu, Yanhui2; Li, Mingzi2; Qiu, Shanhu1,3

2021-12-01

10.3904/kjim.2020.629

KOREAN JOURNAL OF INTERNAL MEDICINE   影响因子和分区

1226-3303

2005-6648

["Background/Aims: Older adults are vulnerable to central obesity, while the association of changes in central fatness with risk of diabetes and metabolic control has not been investigated among this particular population. This study was aimed to address these issues.","Methods: A total of 1,815 adults aged >= 60 years without diabetes at baseline were followed for 4 years. Incident diabetes was ascertained based on plasma glucose, hemoglobin A1c, medical history, and/or the use of anti-diabetic drugs. Central fatness was assessed by waist circumference (WC), waist-height ratio (WHtR), and body roundness index (BRI). Logistic regression analyses were used to assess the association of changes in central fatness with risk of diabetes, along with dose-response and mediation analyses.","Results: During the 4-year follow-up, 177 participants developed diabetes. The risk of diabetes was increased by 42%, 41%, and 40% per 1 standard deviation increases in WC, WHtR, and BRI, respectively, in multivariable-adjusted models (all p < 0.01). Moreover, these relationships were all linearly-shaped (all p(nonlinearity) >= 0.11). Increases in WC, WHtR, and BRI correlated with increases in hemoglobin A1c, triglycerides-and-glucose index, triglycerides, white blood cell, and C-reactive protein (all p <= 0.04). Yet only changes in hemoglobin A1c and triglycerides-and-glucose index were identified as the possible mediators for risk of diabetes, with their mediating effect being about 35% and 21%, respectively.","Conclusions: Increases in central fatness were related to elevated risk of diabetes, and this association might be partly explained by the worsening of glycemic control and insulin resistance in older adults."]

Aged Obesity Follow-up studies Insulin resistance Mediation analysis

SCI

英语

其他

General & Internal Medicine

Medicine, General & Internal

WOS:000737496100001

KOREAN ASSOC INTERNAL MEDICINE

CLINICAL MEDICINE

Web of Science

1.Southeast Univ, Zhongda Hosp, Inst Diabet, Nanjing, Peoples R China
2.Peking Univ, Sch Nursing, 38 Xueyuan Rd, Beijing 100191, Peoples R China
3.Jinan Univ, Southern Univ Sci & Technol, Shenzhen Peoples Hosp, Dept Endocrinol,Affiliated Hosp 1,Clin Med Coll 2, Shenzhen, Peoples R China

Cai, Xue,Luo, Dan,Liu, Shuling,et al. Four-year changes in central fatness, risk of diabetes, and metabolic control in older adults: a cohort study with mediation analysis[J]. KOREAN JOURNAL OF INTERNAL MEDICINE,2021.

Cai, Xue.,Luo, Dan.,Liu, Shuling.,Li, Ruxue.,Lu, Yanhui.,...&Qiu, Shanhu.(2021).Four-year changes in central fatness, risk of diabetes, and metabolic control in older adults: a cohort study with mediation analysis.KOREAN JOURNAL OF INTERNAL MEDICINE.

Cai, Xue,et al."Four-year changes in central fatness, risk of diabetes, and metabolic control in older adults: a cohort study with mediation analysis".KOREAN JOURNAL OF INTERNAL MEDICINE (2021).