Associação de índices antropométricos novos e antigos com diabetes melito tipo 2 e risco de complicações metabólicas: um estudo analítico de corte transversal

Amiri, Parichehr; Javid, Ahmad Zare; Moradi, Leila; Haghighat, Neda; Moradi, Rahim; Behbahani, Hossein Bavi; Zarrin, Milad; Bazyar, Hadi

doi:10.1590/1677-5449.200236

Brazil

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ORIGINAL ARTICLE • J. Vasc. Bras. 20 • 2021 • https://doi.org/10.1590/1677-5449.200236 linkcopiar

Associação de índices antropométricos novos e antigos com diabetes melito tipo 2 e risco de complicações metabólicas: um estudo analítico de corte transversal

Autoria SCIMAGO INSTITUTIONS RANKINGS

Resumo

Contexto A obesidade pode aumentar o risco de diabetes melito e complicações associadas.

Objetivos O objetivo deste estudo foi estimar a associação de índices antropométricos novos e antigos com o risco de diabetes melito tipo 2 (DM2) e suas complicações metabólicas.

Métodos Neste estudo analítico transversal, 110 indivíduos com DM2 e 110 controles saudáveis foram selecionados por amostragem de conveniência. Foram avaliados os fatores metabólicos, incluindo índice aterogênico plasmático, estado glicêmico, perfil lipídico, pressão arterial, índices renais, índices antropométricos novos [índice de volume abdominal (AVI), índice de formato corporal (ABSI), produto de acumulação lipídica (LAP), índice de adiposidade corporal (BAI) e índice de conicidade (CI)] e índices antropométricos antigos [peso, índice de massa corporal (IMC), circunferência de cintura e quadril].

Resultados Foi observada uma correlação positiva significativa de AVI, LAP e BAI com glicemia de jejum e hemoglobina glicada no grupo DM2 (p para todos < 0,001). A odds ratio (OR) do grupo DM2 foi significativamente elevada com aumento de IMC [OR: 1,30, intervalo de confiança (IC) de 95%: 1,20-1,42], LAP (OR: 1,20, IC95%: 1,13-1,27) e BAI (OR: 1,32, IC95%: 1,21-1,43). Os índices AVI (OR: 1,90, IC95%: 1,57-2,29), LAP (OR: 1,19, IC95%: 1,13-1,27), BAI (OR: 1,19, IC95%: 1,12-1,26), WC (OR: 1,29, IC95%: 1,18-1,42) e HC (OR: 1,07, IC95%: 1,01-1,14) aumentaram significativamente o risco de síndrome metabólica.

Conclusões Foi reconhecida uma associação entre índices de obesidade e diabetes. Esses índices podem ser usados na prática clínica para avaliação e controle do DM2.

Palavras-chave: antropometria; obesidade; diabetes melito tipo 2; medidas de associação; exposição; risco ou resultado

Variables	Healthy group	Diabetic group	*P- value*
Age (y)	51.62 ± 5.6	50.65 ± 5.31	0.18
Gender
Female (N) (%)	72 (49)	75 (51)	0.66 *
Male (N) (%)	38 (52.1)	35 (47.9)
Education
Illiterate – elementary (N) (%)	64 (43.8)	82 (56.2)	0.056*
Middle school (N) (%)	24 (60)	16 (40)
High school (N) (%)	13 (59.1)	9 (40.9)
College (N) (%)	9 (75)	3 (25)
Total	110	110
Weight (kg)	66.79 ± 7.91	75.94 ± 11.52	<0.001
Height (cm)	165.78 ± 8.83	164.18 ± 10.87	0.23
Body mass index (kg/m²)	24.45 ± 3.57	28.22 ± 3.82	<0.001
Waist circumference (cm)	73.81 ± 4.40	103.46 ± 8.73	<0.001
Hip circumference (cm)	95.27 ± 4.05	107.73 ± 8.83	<0.001
Waist-to-hip ratio	0.77 ± 0.04	0.96 ± 0.07	<0.001
Waist-to-height ratio	0.44 ± 0.03	0.63 ± 0.06	<0.001
Physical activity (MET-min/week)	961.12 ± 548.26	286.93 ± 154.77	<0.001
Fasting blood glucose (mg/dL)	87.69 ± 7.78	165.17 ± 31.39	<0.001
Hemoglobin A1c %	4.84 ± 0.46	8.34 ± 1.31	<0.001
Triglycerides (mg/dL)	156.86 ± 62.22	148.94 ± 38.29	0.25
Total cholesterol (mg/dl)	167.29 ± 64.89	159.37 ± 34.55	0.26
High-density lipoprotein cholesterol (mg/dl)	47.50 ± 10.43	42.55 ± 10.28	<0.001
Low-density lipoprotein cholesterol (mg/dl)	89.27 ± 38.37	98.18 ± 41.76	0.1
Very low-density lipoprotein cholesterol (mg/dl)	31.37 ± 12.44	29.78 ± 7.65	0.25
Low-density/high-density lipoprotein cholesterol	2.04 ± 1.07	2.45 ± 1.36	0.01
Atherogenic index of plasma	0.49 ± 0.22	0.54 ± 0.15	0.08
Estimated glomerular filtration rate (mL/min/1.73m²)	80.23 ± 16.56	79.62 ± 18.32	0.79
Blood urea nitrogen (mg/dL)	12.69 ± 2.23	13.34 ± 3.01	0.07
Creatinine (mg/dL)	0.80 ± 0.14	0.86 ± 0.15	0.006
Albuminuria (mg/24h)	5.60 ± 2.09	10.62 ± 4.29	<0.001
Systolic blood pressure (mmHg)	118.72 ± 9.96	125.36 ± 13.11	<0.001
Diastolic blood pressure (mmHg)	73.45 ± 7.34	76.18 ± 8.34	0.01
Mean arterial pressure (mmHg)	88.54 ± 7.41	92.57 ± 8.40	<0.001
Pulse pressure (mmHg)	45.27 ± 7.98	49.18 ± 12.20	0.005
A body shape index (m^11/6 Kg^-2/3)	0.036 ± 0.01	0.037 ± 0.01	0.35
Abdominal volume index	10.93 ± 1.29	21.56 ± 3.54	<0.001
Conicity index	1.06 ± 0.08	1.40 ± 0.15	<0.001
Lipid accumulation product	24.45 ± 12.69	73. 43 ± 26.25	<0.001
Body adiposity index (Kg/m²)	26.87 ± 4.01	33.59 ± 6.39	<0.001
Metabolic syndrome
Yes	0 (0)	77 (70)	<0.001*
No	110 (100)	33 (30)
Total	110 (100)	110 (100)

Variables	Or (CI)	B	^* * P <0.05 statistically significant according to multivariate logistic regression; *P- value*
Body adiposity index (Kg/m²)
Model 1a	1.32 (1.21-1.43)	0.27	< 0.001
Model 2b	1.34 (1.23-1.46)	0.29	< 0.001
Model 3c Model 4d	1.31 (1.17-1.46) 1.33 (1.10-1.62)	0.27 0.29	< 0.001 0.003
Lipid accumulation product
Model 1^a	1.20 (1.13-1.27)	0.18	< 0.001
Model 2^b	1.21 (1.13-1.28)	0.19	< 0.001
Model 3^c	1.30 (1.15-1.46)	0.26	< 0.001
Model 4^d	1.21 (1.06-1.37)	0.19	0.003
Abdominal volume index
Model 1^a	28.38 (0.99-812.80)	3.34	0.051
Model 2^b	29.34 (0.91-937.89)	3.37	0.056
Model 3^c	59.83 (0.43-8206.14)	4.09	0.10
Model 4^d	54.09 (0.29-10003.22)	16.19	0.98
Weight
Model 1^a	1.10 (1.06-1.13)	0.09	< 0.001
Model 2^b	1.10 (1.06-1.14)	0.09	< 0.001
Model 3^c	1.08 (1.03-1.13)	0.08	< 0.001
Model 4^d	1.16 (1.04-1.30)	0.15	0.006
Body mass index (kg/m2)
Model 1^a	1.30 (1.20-1.42)	0.26	< 0.001
Model 2^b	1.31 (1.20-1.42)	0.26	< 0.001
Model 3^c	1.36 (1.19-1.56)	0.30	< 0.001
Model 4^d	1.29 (1.05-1.58)	0.25	0.01
Waist circumference (cm)
Model 1^a	2.95 (1.02-8.55)	1.08	0.045
Model 2^b	2.98 (0.99-8.93)	1.09	0.050
Model 3^c	3.74 (0.78-17.85)	1.32	0.09
Model 4^d	56.34 (0.001- 5.977E)	4.03	0.98
Hip circumference (cm)
Model 1^a	1.44 (1.30-1.60)	0.37	< 0.001
Model 2^b	1.45 (1.31-1.61)	0.37	< 0.001
Model 3^c	1.37 (1.22-1.55)	0.32	< 0.001
Model 4^d	1.50 (1.31- 2.00)	0.40	0.005

Variables	Waist/height R P- value^* * P <0.05 was considered as significant using the Pearson test for correlation between variables. R was considered as correlation coefficient.		A body shape index R P- value*		Abdominal volume index R P- value*		Conicity index R P- value*		Lipid accumulation product R P- value*		Body adiposity index R P- value*
Fasting blood glucose (mg/dL)	0.75	< 0.001	0.05	0.41	0.78	< 0.001	0.70	< 0.001	0.74	< 0.001	0.49	< 0.001
Hemoglobin A1c %	0.74	< 0.001	0.06	0.33	0.75	< 0.001	0.75	< 0.001	0.73	< 0.001	0.46	< 0.001
Low-density lipoprotein cholesterol (mg/dl)	0.15	0.02	-0.1	0.13	0.14	0.02	0.08	0.21	0.24	< 0.001	0.12	0.059
High-density lipoprotein cholesterol (mg/dl)	-0.23	< 0.001	0.07	0.28	-0.22	0.001	-0.18	0.005	-0.24	< 0.001	-0.09	0.14
Triglycerides (mg/dL)	-0.06	0.31	0.002	0.97	-0.04	0.46	-0.06	0.33	0.36	< 0.001	-0.08	0.20
Total cholesterol (mg/dl)	-0.06	0.35	-0.08	0.2	-0.05	0.42	-0.1	0.13	0.16	0.01	-0.07	0.30
Low-density-to-high-density lipoprotein cholesterol	0.22	0.001	-0.09	0.15	0.21	0.001	0.15	0.02	0.29	< 0.001	0.14	0.03
Very low-density lipoprotein cholesterol (mg/dl)	-0.06	0.31	0.002	0.97	-0.04	0.46	-0.06	0.33	0.36	< 0.001	-0.08	0.20
Atherogenic index of plasma	0.12	0.07	-0.04	0.52	0.12	0.057	0.09	0.18	0.42	< 0.001	0.01	0.84
Blood urea nitrogen (mg/dL)	0.16	0.01	-0.05	0.42	0.14	0.03	0.11	0.07	0.1	0.12	0.07	0.24
Creatinine (mg/dL)	0.17	0.01	-0.01	0.8	0.20	0.002	0.14	0.03	0.23	< 0.001	0.08	0.19
Albuminuria (mg/24h)	0.48	< 0.001	0.01	0.87	0.50	< 0.001	0.44	< 0.001	0.44	< 0.001	0.35	< 0.001
Estimated glomerular filtration rate (mL/min/1.73m2)	-0.01	0.83	0.1	0.12	-0.05	0.44	0.02	0.67	-0.02	0.74	0.08	0.23
Systolic blood pressure (mmHg)	0.27	< 0.001	-0.05	0.45	0.26	< 0.001	0.22	0.001	0.22	0.001	0.25	< 0.001
Diastolic blood pressure (mmHg)	0.17	0.009	-0.1	0.78	0.18	0.007	0.14	0.03	0.13	0.04	0.15	0.01
Mean arterial pressure (mmHg)	0.25	< 0.001	-0.03	0.58	0.24	< 0.001	0.2	0.002	0.2	0.003	0.22	0.001
Pulse pressure (mmHg)	0.18	0.005	-0.04	0.5	0.16	0.01	0.14	0.03	0.15	0.01	0.17	0.01

Variable	Or (CI)	B	^* * P < 0.05 statistically significant according to multivariate logistic regression; *P- value*
Body adiposity index (Kg/m²)
Model 1a	1.19 (1.12-1.26)	0.17	< 0.001
Model 2b	1.19 (1.12-1.27)	0.17	< 0.001
Model 3c Model 4d	1.12 (1.05-1.19) 1.09 (1.01-1.17)	0.11 0.08	< 0.001 0.01
Lipid accumulation product Model 1^a	1.19 (1.13-1.27)	0.18	< 0.001
Model 2^b Model 3^'	1.20 (1.13-1.28)	0.18	< 0.001
Model 2^b Model 3^'	1.19 (1.12-1.27)	0.17	< 0.001
Model 4^d	1.21 (1.06-1.37)	0.19	0.003
Abdominal volume index
Model 1^a	1.90 (1.57-2.29)	0.64	< 0.001
Model 2^b	1.94 (1.60-2.35)	0.66	< 0.001
Model 3^c	1.94 (1.57-2.40)	0.66	< 0.001
Model 4^d	1.97 (1.58-2.46)	0.68	< 0.001
Weight
Model 1^a	1.05 (1.02, 1.08)	0.05	< 0.001
Model 2^b	1.05 (1.02, 1.08)	0.05	< 0.001
Model 3^c	1.01 (0.98, 1.05)	0.01	0.23
Model 4^d	1.00 (0.96, 1.04)	0.002	0.90
Body mass index (kg/m²)
Model 1^a	1.14 (1.06, 1.23)	0.13	< 0.001
Model 2^b	1.14 (1.06, 1.23)	0.13	< 0.001
Model 3^c	1.06 (0.98, 1.16)	0.06	0.11
Model 4^d	0.99 (0.89, 1.10)	-0.008	0.87
Waist circumference (cm)
Model 1^a	1.28 (1.19, 1.38)	0.25	< 0.001
Model 2^b	1.29 (1.19, 1.40)	0.25	< 0.001
Model 3^c	1.29 (1.19, 1.41)	0.26	< 0.001
Model 4^d	1.29 (1.18, 1.42)	0.26	< 0.001
Hip circumference (cm) Model 1^a	1.19 (1.13, 1.25)	0.17	< 0.001
Model 2^b	1.20 (1.14, 1.26)	0.18	< 0.001
Model 3^c	1.13 (1.07, 1.19)	0.12	< 0.001
Model 4^d	1.07 (1.01, 1.14)	0.07	0.009

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[1] Values are expressed as means ± SD. P <0.05 was considered as significant using the independent t test for comparison between the two groups;

[TFN1] ^*
P <0.05 was considered as significant using the Chi-square test.