| Objective:We retrospectively collected clinical data from patients with type 2 diabetes mellitus(T2DM)to explore the correlation and predictive value of body mass index(BMI),waist circumference-to-height ratio(WHt R),waist circumference(WC),lipid accumulation index(LAP),visceral fat index(VAI),body shape index(ABSI),body roundness index(BRI)and metabolic syndrome(MS)in anthropometric indicators of patients with T2 DM.Method:1.Patients with type 2 diabetes admitted to endocrinology Department of our hospital from May 2019 to December 2021 were collected.They were divided into MS group and non-MS group.We collect clinical data from patients,and calculate the insulin resistance index(HOMA-IR)and anthropometric indicators such as BMI,WHt R,LAP,VAI.etc.2.SPSS Software 26.0 was used to analyze the differences between the two groups.According to the gender grouping,logistic regression was used to analyze whether each anthropometric index was an independent risk factor for MS in patients with T2 DM.The ROC curve was used to analyze the value of various anthropometric indicators in predicting MS,and Medclac software 20.0.14 was used to analyze the difference of anthropometric indicators in predicting MS.Result:1.Baseline data analysis: A total of 290 patients with T2 DM were collected,including 97(33.45%)in the non-MS group and 193(66.55%)in the MS group.There were significant differences in systolic blood pressure,diastolic blood pressure,TG,HDL-C,CRE,UA and homa-IR between the two groups(P<0.05),and the levels of BMI,WC,WHt R,LAP,VAI,ABSI and BRI in the MS group were higher than those in the non-MS group,and the differences were statistically significant(P<0.05).The prevalence was greater in the MS group than in the non-MS group,and there was a statistically significant difference between the two groups(P<0.05).2.Comparison of macrovascular prevalence:There were 108 cases(55.96%)in the MS group and 45(46.39%)in the non-MS group with carotid atherosclerosis,and there was no significant difference between the two groups(P>0.05);118 cases(61.14%)in the MS group and 62 cases(63.92%)in the non-MS group with atherosclerosis of both lower extremities,and there was no significant difference between the two groups(P>0.05).3.Comparison of the prevalence of microvascular complications:There were 94cases(48.70%)in the non-proliferative MS group and 27(27.80%)in the non-MS group with diabetic retinopathy,and the prevalence rate in the MS group was higher than that in the non-MS group,and there was a statistically significant difference between the two groups(P<0.05).45 patients(23.32%)had microalbuminuria and 24patients(12.43%)had macroalbuminuria.There were 11 cases of microalbuminuria(11.34%)and 3 cases of macroalbuminuria(3.09%)in the non-MS group.The prevalence of diabetic nephropathy in the MS group was higher than that in the non-MS group,and there was statistical difference between the two groups(P < 0.05).4.By gender,the anthropometric indexes were divided into Q1,Q2,Q3,and Q4 groups according to the quartiles,and logistic univariate regression analysis was carried out,regardless of male or female,the risk of MS in Q3 and Q4 groups of BMI,WC,WHt R,LAP,VAI,AND BRI was higher than that in Q1 group(P<0.05),The risk of MS in the ABSI Q4 group was higher than in the Q1 group(P<0.05).Multivariate logistic regression analysis was carried out to include confounding factors,and the BMI,WC,WHt R,LAP,VAI,BRI and ABSI values were high in the male group,which were independent risk factors for MS(P<0.05),while the BMI,WC,LAP,VAI,and BRI values were high in the female group,which were independent risk factors for MS(P<0.05).5.The results of the subject’s working curve(ROC curve)predicting the occurrence of MS were plotted using anthropometric indicators: the AUC of male BMI,WC,WHt R,LAP,VAI,ABSI,and BRI for predicting MS was 0.757,0.844,0.827,0859,0.753,0.654,0.827,and the optimal cut-off values were 24.82 kg/m2,91.25 cm,0.52,30.42,1.83,0.083,respectively,3.79,the AUCs of female BMI,WC,LAP,VAI and BRI predicted MS were 0.75,0.823,0.883,0.824 and 0.808,respectively,and the optimal cut-off values were 25.21 kg/m2,88.5 cm,48.14,2.84,and 4.25,respectively.LAP has the largest AUC in both men and women.6.The Z-test was used to compare differences in anthropometric measures in predicting MS.The results showed that LAP and WC had better predictive value for MS in patients with type 2 diabetes,and the predictive value was better than BMI.Conclusion:1.In patients with T2 DM,elevated BMI,WC,WHt R,LAP,VAI,ABSI,and BRI values were independent risk factors for MS,and elevated BMI,WC,LAP,VAI,and BRI values in women were independent risk factors for MS.2.LAP and WC can be used as good indicators for T2 DM patients to predict the occurrence of MS,and the predictive value is better than that of traditional measurement BMI.3.LAP predicted that the optimal cut-off point for MS in T2 DM patients was30.42 for men and 48.14 for women.The optimal cut-off point for predicting MS in T2 DM patients by WC was 91.25 cm in men and 88.5cm in women. |
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