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- Title
Hypertriglyceridaemic–waist phenotype and risk of diabetes in people with impaired fasting glucose in primary care: a cohort study.
- Authors
Guo, V. Y.‐W.; Yu, E. Y.‐T.; Wong, C. K.‐H.; Sit, R. W.‐S.; Wang, J. H.‐L.; Lam, C. L.‐K.
- Abstract
Abstract: Aim: We aimed to determine the prospective association between baseline triglyceridaemic–waist phenotypes and diabetic mellitus incidence in individuals with impaired fasting glucose seen in primary care. Methods: A cohort of 1101 participants (84.4% of the recruited individuals) with impaired fasting glucose were recruited from three primary care clinics during regular follow‐ups to monitor their chronic conditions. Baseline triglyceridaemic–waist phenotypes were divided into four groups: (1) normal waistline and triglyceride level (<italic>n</italic> = 252); (2) isolated central obesity (<italic>n</italic> = 518); (3) isolated high triglyceride level (<italic>n</italic> = 80); and (4) central obesity with high triglyceride level (i.e. hypertriglyceridaemic–waist phenotype) (<italic>n</italic> = 251). The presence of diabetes at follow‐up was determined by fasting plasma glucose (≥ 7.0 mmol/l) and/or 2‐h 75‐g oral glucose tolerance test (≥ 11.1 mmol/l) and/or HbA1c (47.5 mmol/mol; ≥ 6.5%) according to American Diabetes Association diagnostic criteria. Multivariable Cox proportional hazards regressions were established to assess the impact of different triglyceridaemic–waist phenotypes on time to diabetes onset. Results: After a mean follow‐up period of 6.5 months ( sd 4.7 months), the number of diabetes cases was significantly higher in the group with hypertriglyceridaemic–waist phenotype (52.2%) compared with the other three phenotype groups (group 1: 28.2%; group 2: 34.6%; group 3: 30.0%). Only the hypertriglyceridaemic–waist phenotype showed an increased risk of developing diabetes (hazard ratio 1.581, 95% CI 1.172–2.134; <italic>P</italic> = 0.003) compared with the group with normal waistline and triglyceride level after controlling for confounders. Conclusions: The combination of central obesity and hypertriglyceridaemia is associated with > 50% risk of progression to diabetes within 6 months among individuals with impaired fasting glucose seen in primary care.
- Subjects
DIABETES risk factors; COMPARATIVE studies; CONFIDENCE intervals; GLUCOSE tolerance tests; GLYCOSYLATED hemoglobin; HYPERCHOLESTEREMIA; PRIMARY health care; PROBABILITY theory; TRIGLYCERIDES; PHENOTYPES; STATISTICAL significance; PROPORTIONAL hazards models; WAIST circumference; DESCRIPTIVE statistics; ABDOMINAL adipose tissue; ODDS ratio
- Publication
Diabetic Medicine, 2018, Vol 35, Issue 5, p576
- ISSN
0742-3071
- Publication type
Article
- DOI
10.1111/dme.13601