Association between hypertriglyceridemic waist phenotype and Diabetes mellitus in adults: a case-control study
DOI:
https://doi.org/10.33448/rsd-v11i6.29328Keywords:
Hypertriglyceridemic waist; Waist circumference; Diabetes mellitus.Abstract
Diabetes mellitus (DM) is considered a major public health problem. Studies in several countries points to the usefulness of evaluating the hypertriglyceridemic waist (HTC) phenotype to predict the risk of the disease. Aim: This study aimed to evaluate the association between the HTC phenotype and DM type 2 in Dourados, MS, Brazil. Methods: This is a case-control study nested within a population-based cross-sectional survey with multiple-stage sampling, carried out in 2016. The sample included 293 adults aged 20 to 59 years, of which 56 were cases and 237 controls. The cases were those with fasting blood glucose ≥ 126mg/dL and who reported that “a doctor or health professional has already said that “Do you have high blood sugar?” Controls were drawn from the other interviewees, without DM. Individuals with waist circumference (WC) were considered to have the HTC phenotype: ≥ 80 cm for women and ≥ 90 cm for men, combined with hypertriglyceridemia (TG) ≥ 150 mg/dL. The variables gender, age, education, socioeconomic status, smoking, alcohol consumption, physical activity and body mass index were investigated. Chi-Square Test, Fisher's Exact Test and Unconditional Logistic Regression were used for data analysis. Results: The HTC phenotype was positively associated with DM: 2.08, 95%CI: 1.04-4.12, after adjusting for covariates. Conclusion: The study suggests that the HTC phenotype may be useful as an approach in the identification of DM.
References
American Diabetes Association. (2017). Classification and Diagnosis of Diabetes. Diabetes Care, 40(suppl.1), S11-S24. doi: https://doi.org/10.2337/dc17-S005
American Diabetes Association. (2005). Standards of medical care in diabetes. Diabetes Care, 28(suppl. 1), S4-S36. doi: https://doi.org/10.2337/diacare.28.suppl_1.S4
Amini, M., Esmaillzadeh, A., Sadeghi, M., Mehvarifar, N., & Zare, M. (2011). The association of hypertriglyceridemic waist phenotype with type 2 diabetes mellitus among individuals with first relative history of diabetes. Journal of Research in Medical Sciences, 16(2), 156-164.
Associação Brasileira das Empresas de Pesquisas. (2010). Critério de Classificação Econômica Brasil 2012: base LSE 2010. São Paulo: Abep.
Brasil. Ministério da Saúde. (2018). Vigitel Brazil 2017: surveillance of risk and protective factors for chronic diseases by telephone survey: estimates of Frequency and sociodemographic distribution of risk and protective factors for chronic diseases in the capitals of the 26 Brazilian states and the Federal District in 2017. Brasília: Ministério da Saúde.
Cabral, N. A., Ribeiro, V. S., Franca, A. K., Salgado, J. V., Santos, A. M., Salgado, N. Filho, & Silva, A. A. M. (2012). Hypertriglyceridemic waist and cardiometabolic risk in hypertensive women. Revista da Associação Médica Brasileira, 58(5), 568-573.
Chen, S., Guo, X., Yu, S., Sun, G., Li, Z., & Sun, Y. (2016). Association between the Hypertriglyceridemic Waist Phenotype, Prediabetes, and Diabetes Mellitus in Rural Chinese Population: A Cross-Sectional Study. Department of Cardiology, the First Affiliated Hospital of China Medical University. International Journal of Environmental Research and Public Health, 13(4), 368-376.
Cortés, J. M., Morató, T. M., Toro, R., Pérez, J. M., & Rojas, A. M. (2015). Sindrome metabólico en pacientes con fenotipo clínico de “cintura hipertrigliceridémica”. Nutricion hospitalaria, 32(3), 1145-1152.
Després, J. P. (2012). Body fat distribution and risk of cardiovascular disease: an update. Circulation, 126(10), 1301-1313.
Diaz-Santana, M. V., Perez, E. L. S., Martinez, A. P. O., Serrano, M. G., & Cardona, C. M. P. (2016). Association Between the Hypertriglyceridemic Waist Phenotype, Prediabetes, and Diabetes Mellitus Among Adults in Puerto Rico. Journal of Immigrant and Minority Health, 18(1), 102-109.
Du, T., Sun, X., Huo, R., & Yu, X. (2014). Visceral adiposity index, hypertriglyceridemic waist and risk of diabetes: the China Health and Nutrition Survey 2009. International Journal of Obesity, 38, 840-847.
Egeland, G. M., Cao, Z., & Young, T. K. (2011). Hypertriglyceridemic-waist phenotype and glucose intolerance among Canadian Inuit: the International Polar Year Inuit Health Survey for Adults 2007-2008. Canadian Medical Association Journal, 183(9), E553-E558. doi: https://doi.org/10.1503/cmaj.101801
Flores, L. S., & Campos, M. R. (2017). The prevalence of diabetes mellitus and its associated factors in the Brazilian adult population: evidence from a population-based survey. Revista Brasileira de Epidemiologia, 20(1), 16-20.
Fontanelli, M. M., Teixeira, J. A., Sales, C. H., Castro, M. A., Cesar, C. L. G., Alves, M. C. P., ... Fisberg, R. M. (2017). Validation of self-reporter diabetes in a representative sample of São Paulo city. Revista de Saúde Pública, 51, 20. doi: https://doi.org/10.1590/s1518-8787.2017051006378
Freitas, R. S., Fonseca, M. J., Schimdt, M. I., Molina, M. C., & Almeida, M. C. (2016). Cintura hipertrigliceridêmica e fatores associados no Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil). Cadernos de Saúde Pública, 34(4), e000067617. doi: https://doi.org/10.1590/0102-311X00067617
Giraldoni, A. F. M., Rodríguez, M. B., Rodríguez, V. S., Álpizar, E. R., Mendoza, E. M., & Borrero, A. A. N. (2018). Fenótipo hipertrigliceridemia cintura abdominal alterada y su asociación con los factores de riesgo cardiovasculares. Revista Habanera de Ciencias Médicas, 17(6), 949-964.
Halty, L. S., Huttner, M. D., Oliveira, I. C. Netto, Santos, V. A., & Martins, G. (2002). Análise da utilização do Questionário de Tolerância de Fagertron (QTF) como instrumento de medida de dependência nicotínica. Jornal de Pneumologia, 28(4), 180-186.
Han, K. J., Lee, S. Y., Kim, N. H., Chae, H. B., Lee, T. H., Jang, C. M., … Rhee, E. J. (2014). Increased risk of diabetes development in subjects with the hypertriglyceridemic waist phenotype: a 4-year longitudinal study. Endocrinology and Metabolism, 29(4), 514-521.
Hardy, O. T., Czech, M. P., & Corvera, S. (2012). What causes the insulin resistance underlying obesity? Current Opinion in Endocrinology, Diabetes and Obesity, 19(2), 81-87.
International Diabetes Federation. (2017). IDF Diabetes Atlas. 8th edition. Brussels: International Diabetes Federation.
Janghorbani, M., & Amini, M. (2016). Utility of hypertriglyceridemic waist phenotype for predicting incident type 2 diabetes: The Isfahan Diabetes Prevention Study. Journal of Diabetes Investigation, 7(6), 860-866.
Kahn, H. S., & Cheng, Y. J. (2008). Longitudinal changes in BMI and in an index estimating excess lipids among white and black adults in the United States. International Journal of Obesity, 32(1), 136-143.
Lemieux, I., Pascot, A., Couillard, C., Lamarche, B., Tchernof, A., Almeras, N., … Després, J. P. (2000). Hypertriglyceridemic waist: A marker of the atherogenic metabolic triad (hyperinsulinemia; hyperapolipoprotein B; small, dense LDL) in men? Circulation, 102(2),179-184.
Lemieux, I., Poirier, P., Bergeron, J., Almeras, N., Lamarche, B., Cantin, B., … Després, J. P. (2007). Hypertriglyceridemic waist: a useful screening phenotype in preventive cardiology? The Canadian Journal of Cardiology, 23(suppl. B), B23-B31.
Lima, C. L. J., Ferreira, T. M. C., Oliveira, P. S., Ferreira, J. D. L., Silva, E. C., & Costa, M. M. L. (2018). Characterization of users at risk of developing diabetes: a cross-sectional study. Revista Brasileira de Enfermagem, 71(supl.2), 475-482.
Lohman, T. G., Roche, A. F., & Martorell, R. (1988). Anthropometric Standardization Reference Manual. Illinois: Human Kinetics Books.
Ma, C. M., Liu, X. L., Lu, N., Wang, R., Lu, Q., & Yin, F. Z. (2019). Hypertriglyceridemic waist phenotype and abnormal glucose metabolism: a system review and meta-analysis. Endocrine, 64(3), 469-485.
Malta, D. C., Bernal, R. T. I., Lima, M. G., Araújo, S. S. C., Silva, M. M. A., Freitas, M. I. F., & Barros, M. B. A. (2017). Doenças crônicas não transmissíveis e a utilização de serviços de saúde: análise da Pesquisa Nacional de Saúde no Brasil. Revista de Saúde Pública, 51(supl.1), S1-S10.
Matsudo, S., Araujo, T., Matsudo, V., Andrade, D., Andrade, E., Oliveira, L. C., & Braggion, G. (2012). Questionário internacional de atividade física (IPAQ): estudo de validade e reprodutividade no Brasil. Revista Brasileira de Atividade Física & Saúde, 6(2), 5-18.
Oliveira, C. C., Roriz, A. K. C., Eickemberg, M., Medeiros, J. M. B., & Ramos, L. B. (2014). Hypertriglyceridemic waist phenotype: association with metabolic disorders and visceral fat in adults. Nutricion hospitalaria, 30(1), 25-31.
Oliveira, J., Lopes, L. L., Pelúzio, M. C. G., & Hermsdorff, H. H. M. (2014). Hypertriglyceridemic Waist Phenotype and Cardiometabolic Risk in Dyslipidemic Subjects. Federal University of Viçosa − Department of Nutrition and Health − Viçosa, MG – Brazil. Revista Brasileira de Cardiologia Invasiva, 27, 395-402.
Organização Mundial de Saúde. (1995). Estado físico. Uso e interpretação da antropometria. Genebra: OMS.
Pires, R. O. M., & Webster, C. M. C. (2011). Adaptation and validation of the Alcohol. Use Disorders Identification Test (AUDIT) for a river population in the Brazilian Amazon. Cadernos de Saúde Pública, 27(3), 497-509.
Pollex, R. L., Hanley, A. J., Zinman, B., Harris, S. B., & Hegele, R. A. (2006). Clinical and genetic associations with hypertriglyceridemic waist in a Canadian aboriginal population. International Journal of Obesity, 30(3), 484-491.
Primea, U. V., Coderre, L., Karelis, A. D., Brochu, M., Lavoie, M. E., Messier, V., … Rabasa-Lhoret, R. (2011). Characterizing the profile of obese patients who are metabolically healthy. International Journal of Obesity, 35(7), 971-981.
Reid, M. J. A., Tsima, B. M., & Kirk, B. (2012). HIV and diabetes in Africa. African Journal of Diabetes Medicine, 20(2), 28-32.
Ren, Y., Zhang, M., Zhao, J., Wang, C., Luo, X., Zhang, J., … Hu, D. (2016). Association of the hypertriglyceridemic waist phenotype and type 2 diabetes mellitus among adults in China. Journal of Diabetes Investigation, 7(5), 689-694.
Riserus, U., Faire, U. D., Berglund, L., & Hellénius, M. L. (2010). Sagittal abdominal diameter as a screening tool in clinical research: cutoffs for cardiometabolic risk. Journal of Obesity, 2010, e757939. doi: https://doi.org/10.1155/2010/757939
Rocha, A. L. C., Pereira, P. F., & Pessoa, M. C. (2015). Hypertriglyceridemic waist phenotype and cardiometabolic alterations in Brazilian adults. Nutricion hospitalaria, 32(3), 1099-1106.
Rossaneis, M. A., Haddad, M. C. F. L., Mathias, T. A. F., & Marcon, S. S. (2016). Diferenças entre mulheres e homens diabéticos no autocuidado com os pés e estilo de vida. Revista Latino-Americana de Enfermagem, 24, e2761. doi: https://doi.org/10.1590/1518-8345.1203.2761
Sam, S., Haffner, S., Davidson, M. H., D'Agostino, R. B. Sr., Feinstein, S., Kondos, G., … Mazzone, T. (2009). Hypertriglyceridemic waist phenotype predicts increased visceral fat in subjects with type 2 diabetes. Diabetes Care, 32(10), 1916-1920.
Schmidt, M. I., Hoffmann, J. F., Diniz, M. F. S., Lotufo, P. A., Griep, R. H., Bensenor, I. M., ... Duncan, B. B. (2014). High prevalence of diabetes and intermediate hyperglycemia − The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Diabetology & Metabolic Syndrome, 6(123), 1-9.
Stefan, N., Kantartzis, K., Machann, J., Schick, F., Thamer, C., Rittig, K., … Häring, H. U. (2008). Identification and characterization of metabolically benign obesity in humans. Archives of Internal Medicine, 168(15), 1609-1616 (2008).
Weschenfelder, C., Marcadenti, A., Stein, A. T., & Gottschall, C. B. (2017). Enlarged waist combined with elevated triglycerides (hypertriglyceridemic waist phenotype) and HDL-cholesterol in patients with heart failure. São Paulo Medical Journal, 135(1), 50-56.
Whiting, D., Unwin, N., & Roglic, G. (2010). Diabetes: equity and social determinants. In E. Blas & A. Kurup (Eds.), Equity, social determinants and public health programmes (pp. 77-94). Geneva, Switzerland: World Health Organization.
Wild S., Roglic, G., Green, A., Sicree, R., & King, H. (2004). Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care, 27(5), 1047-1053.
World Health Organization. (2018). Global report on diabetes. Geneva: WHO.
Zhao K., Yang S. S., Wang, H. B., Chen K., Lu, Z. H., & Mu, Y. M. (2018). Association between the Hypertriglyceridemic Waist Phenotype and Prediabetes in Chinese Adults Aged 40 Years and Older. Journal of Diabetes Research, 2018, e1031939. doi: https://doi.org/10.1155/2018/1031939
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Caroline Wünsch; Syssa Reino Zanovello; Stephanie Ramirez Iahnn; Gabriela Rieveres Borges de Andrade; Rosangela da Costa Lima
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
