Abstract

Fasting plasma glucose (FPG) and obesity-related indices are prognostic factors for adverse outcomes in both subjects with and without diabetes. A few studies have investigated sex differences in obesity indices related to the risk of diabetes, however no studies have compared the relationship between FPG and obesity-related indices by diabetes and sex. Therefore, in this study, we compared the curve shapes of FPG and various obesity-related indices by diabetes, and further explored sex differences in these associations. Data were derived from the Taiwan Biobank database, which included 5000 registered individuals. We used an adjusted generalized linear regression model and calculated the difference of least square means (Lsmean; standard error, SE) for males and females with and without diabetes. Associations between obesity-related indices and fasting glucose level by diabetes and sex groups were estimated, and the ORTHOREG procedure was used to construct B-splines. The post-fitting for linear models procedure was used to determine the range at which the trends separated significantly. The diabetes/sex/FPG interaction term was significant for all obesity-related indices, including body mass index, waist circumference, hip circumference, waist-to-hip ratio, waist-to-height ratio, lipid accumulation product, body roundness index, conicity index, body adiposity index and abdominal volume index. B-spline comparisons between males and females did not reach significance. However, FPG affected the trend towards obesity-related indices. As the fasting glucose level increased, the values of obesity-related indices varied more obviously in the participants without diabetes than in those with diabetes mellitus. The current study revealed that there was a different relationship between FPG and obesity-related indices by diabetes and sex. FPG affected the trend towards obesity-related indices more obviously in participants without diabetes than in those with diabetes. Further studies with a longitudinal design would provide a better understanding of the underlying mechanisms for the relationships.

Highlights

  • Diabetes is a serious health issue with an increasing prevalence worldwide

  • The participants were stratified into four groups according to diabetes mellitus (DM) and sex as follows: DM males (n = 295), non-DM males (n = 2040), DM females (n = 220) and non-DM females (n = 2445)

  • The differences were more obvious in the non-DM group than in the DM group, but gradually declined as the Fasting plasma glucose (FPG) increased in the general Taiwanese population

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Summary

Introduction

Diabetes is a serious health issue with an increasing prevalence worldwide. A recent study estimated a global prevalence of around about 9%, meaning that around 500 million people have diabetes worldwide. The number is expected to increase by 25% in the 10 years and 50% in the 25 years [1].

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