| ObjectivesThe objectives were to investigate the prevalence of obesity,type 2 diabetes mellitus(T2DM),hypertension and dyslipidemia in rural population of Henan province,and to explore the association of body fat percentage with T2DM,hypertension and dyslipidemia,then to evaluate the discriminatory power of body fat percentage for these cardiovascular metabolic diseases.MethodIn this study,a total of 15 885 participants aged 18-74 years were recruited by cluster random sampling method from the Rural Diabetes,Obesity and Lifestyle(RuralDiab)study.Questionnaire survey was conducted by face-to-face interview.Anthropometric measurements and fasting blood samples were obtained.Body fat percentage was measured using bioelectrical impedance analysis.The software of Epidata3.1 was used for data double entry and validation.All data analysis were conducted in SPSS 21.0.Continuous variables were expressed as means±SD and categorical data as number and percentage.Variance analysis was conducted for continuous variables and Chi-square tests were used for categorical variables.According to quartiles,body fat percentage was split into four levels(Q1,Q2,Q3 and Q4).Unconditioned logistic regression was used to evaluate the association of body fat percentage with cardiovascular metabolic diseases,with odds ratios(OR)and 95% confidence interval(95% CI)adjusted for other variables as the index of association strength.The dose-response analysis of body fat percentage with cardiovascular metabolic diseases using restricted cubic spline functions was performed in software of Stata 11.0.The discriminatory power of body fat percentage for cardiovascular metabolic diseases was tested with the receiver-operating characteristic(ROC)curve in Med Calc software.Results1.A total of 15885 subjects were investigated,including 5886 males and 9999 females.The prevalence rates of obesity,T2DM,hypertension and dyslipidemia in male were14.70%,9.04%,28.56% and 34.79%,respectively.The age-adjusted prevalence rates of obesity,T2DM,hypertension and dyslipidemia in male were19.90%,6.25%,20.85% and 41.62%,respectively.Accordingly,the prevalence rates in females were 18.32%,9.72%,29.13% and 27.17%,respectively;and age-adjusted prevalence rates in females were 16.28%,5.77%,18.27% and 22.42%,respectively.2.The result of correlation analysis showed that SBP,DBP,FPG,Insulin,TC,TG,LDL-C were increasing with the increase of body fat percentage levels(P trend<0.001).Inversely,HDL-C was decreasing with the increase of body fat percentage levels.The prevalence of T2DM,hypertension and dyslipidemia were increasing with the increase of body fat percentage levels(P trend<0.001).3.The results of logistic regression showed that compared with Q1,the adjusted association strength of Q2,Q3 and Q4 were increasing with the increase of body fat percentage levels(P trend<0.001).The largest association strength(OR,95%CI)of Q4 with T2DM in males and females were 3.62(2.66,4.93),3.63(2.07,3.34),respectively.Accordingly,the largest association strength of Q4 with hypertension in males and females were 4.15(3.43,5.01)and 3.14(2.70,3.65),respectively.The largest association strength of Q4 with dyslipidemia in males and females were 8.12(6.69,9.84)and 4.17(3.57,4.86),respectively.4.The dose-response analysis indicated that the association strength of body fat percentage with T2DM,hypertension and dyslipidemia were increase nonlinearly with the continuous increases of body fat percentage.While,the range and speed of increase were different in different diseases,the OR of body fat percentage in males presented the bigger and faster increase.5.The results of ROC curve analysis manifested that the optimal cut-off values of body fat percentage for T2DM,hypertension and dyslipidemia in males were 25.4%,25.5% and 24.2%,respectively;and the correspondingly area under the receiver-operating characteristic curve(AUC)were 0.681,0.661 and 0.672,respectively.Accordingly,the cut-off values in females were 33.7%,34.7% and 32.5%,respectively;and AUCs were 0.661,0.677 and 0.635,respectively.Conclusion1.The prevalence of T2DM,hypertension and dyslipidemia in rural population of Henan province were higher,so we should pay attention to prevent and control the cardiovascular metabolic diseases.2.Body fat percentage was associated with the prevalence of T2DM,hypertension and dyslipidemia.The association strength increased with the increase of body fat percentage levels,and nonlinearly increased with the continuous increase.3.The discriminatory power of body fat percentage for T2DM,hypertension and dyslipidemia was limited,and the optimal cut-off value needed to be verified in large samples studies. |
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