Abstract
BackgroundTraditional anthropometric indices are used in diagnosing metabolic syndrome (MetS). This study aimed to propose a novel index, a product of waist and neck circumferences (PWNC), and compared its value with traditional anthropometric parameters in identifying the presence of MetS in Chinese adults with type 2 diabetes mellitus (T2DM).MethodsFrom September 2017 to June 2019, a total of 2017 Chinese adults with T2DM from the National Metabolic Management Center were included and categorized into a MetS group (1575 cases) and a non-MetS group (442 cases). Demographic and metabolic characteristics were compared between the two groups, and logistic regression analysis was performed for MetS. Body mass index (BMI), waist-to-hip ratio (WHR), waist circumference (WC), neck circumference (NC) and PWNC were assessed by constructing receiver operating characteristic (ROC) curves, and the area under the ROC curves was compared by DeLong’s test.ResultsCompared with the non-MetS group, men and women with MetS had higher blood pressure; higher levels of fasting plasma glucose, fasting insulin, and triglycerides (TGs); lower levels of high-density lipoprotein cholesterol (HDL-C); elevated homeostasis model assessment of insulin resistance (HOMA-IR); and higher BMI, WHR, WC, NC and PWNC (all P < 0.01). Logistic regression showed that PWNC, HDL-C, TGs, HOMA-IR, systolic blood pressure, hypertension and hypotensors were independent risk factors for MetS (all P < 0.01). PWNC, WC, NC, WHR and BMI displayed significant values in the ROC for MetS (all P < 0.01), while the area under the curve for PWNC was larger than that for traditional anthropometric parameters (WC, WHR and BMI) in both men and women (all P < 0.01).ConclusionPWNC outperformed traditional anthropometric parameters in identifying the presence of MetS in Chinese adults with T2DM.
Highlights
Traditional anthropometric indices are used in diagnosing metabolic syndrome (MetS)
The diagnostic criteria of MetS vary slightly between guidelines issued by different expert groups [4,5,6,7,8,9,10], but all include obesity, which is even identified as a prerequisite for MetS in the International Diabetes Federation (IDF) guidelines [7]
Participants were included in the study if they were (i) diagnosed with type 2 diabetes mellitus (T2DM) according to the guideline [5] proposed by the World Health Organization in 1999 and (ii) Chinese adults aged 30 years and above
Summary
This study aimed to propose a novel index, a product of waist and neck circumferences (PWNC), and compared its value with traditional anthropometric parameters in identifying the presence of MetS in Chinese adults with type 2 diabetes mellitus (T2DM). Metabolic syndrome (MetS) is a cluster of interrelated risk factors of metabolic origin such as obesity, hyperglycaemia, dyslipidaemia, and hypertension, which are linked to the development of cardiovascular disease. Diabetic patients with MetS have a much higher prevalence of CVD than those without MetS [3, 4]. The MetS definition is useful for physicians to identify patients at high risk for CVD early and reduce the morbidity and mortality of CVD. Central obesity, is associated with insulin resistance (IR) characterized by hyperinsulinaemia and hyperglycaemia, leading to hypertension and dyslipidaemia and promoting atherosclerotic cardiovascular diseases.
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