Associations between Body Composition Indices and Metabolic Disorders in Chinese Adults: A Cross-Sectional Observational Study
Rong Zhang1, Sheng-Yong Dong2, Fei Wang3, Cong Ma3, Xiao-Lan Zhao4, Qiang Zeng3, Ao Fei5
1 International Medical Center, Health Management Institute, Chinese PLA General Hospital, Beijing 100853; Department of Cardiology, Chinese Navy General Hospital, Beijing 100048, China
2 Department of Healthcare, Agency for Offices Administration of PLA, Beijing 100048, China
3 International Medical Center, Health Management Institute, Chinese PLA General Hospital, Beijing 100853, China
4 Department of Health Management Center, Health Management Institute, Southwest Hospital, The Third Military Medical University, Chongqing 400038, China
5 Navy Institutional Organization, Beijing 100841, China
Prof. Qiang Zeng
Health Management Institute, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853
Source of Support: None, Conflict of Interest: None
Background: Obesity induces dyslipidemia, hypertension, glucose intolerance, and inflammatory state, which results in atherogenic processes, diabetes, and cardiovascular disease. We usually use body composition indices, such as body mass index (BMI), body fat percentage (BFP), waist circumference-height ratio (WHtR), and waist-hip ratio (WHR) to reflect the obesity. The aim of this large population-based cross-sectional study was to investigate the associations between body composition indices and metabolic parameters in Chinese adults.
Methods: A total of 12,018 Chinese adults were included. Body composition indices, such as BMI, BFP, WHtR, and WHR, and metabolic parameters, such as systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), triglyceride (TG), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), fasting blood glucose (FBG), 2 h postprandial blood glucose (2h PBG), glycosylated hemoglobin (HbA1c), fasting insulin (FINS), insulin resistance index (HOMA-IR), high-sensitivity C-reactive protein (hs-CRP), and white blood cell count (WBC), were measured and analyzed. All analyses were stratified by gender.
Results: All body composition indices and metabolic parameters except 2h PBG differed significantly between males and females (all P < 0.001). BMI was positively associated with SBP, DBP, LDL-C, TC, TG, FBG, 2h PBG, HbA1c, FINS, HOMA-IR, hs-CRP, and WBC, and inversely associated with HDL-C; similar relationships were identified between the metabolic parameters and BFP, WHtR, and WHR. In the multivariate analysis, the odds of impaired glucose regulation, dyslipidemia, insulin resistance, and increased hs-CRP were 1.36, 1.92, 3.44, and 1.27 times greater in the overweight group than those in the normal weight group, respectively, and 1.66, 3.26, 7.53, and 1.70 times greater in the obese group than those in the normal weight group, respectively. The odds of dyslipidemia and hs-CRP were 1.29 and 1.38 times greater in the BFP ≥28.0% group than in the BFP <28.0% group, respectively. The odds of dyslipidemia, HOMA-IR, and hs-CRP were 1.55, 1.26, and 1.48 times greater in the WHtR ≥0.96 group than in the WHtR <0.96 group, respectively. Among males, the odds of HOMA-IR were 1.46 times greater in the WHR ≥0.54 group than in the WHR <0.54 group. Similar results were observed in females.
Conclusions: This study identified positive associations between all evaluated body composition indices and metabolic parameters in Chinese adults. Among the body composition indices, BMI predicted four of the five evaluated metabolic disorders in both gender groups.
背景: 肥胖可导致血脂异常, 血压升高, 糖代谢异常, 炎症状态, 由此引发动脉粥样硬化, 糖尿病, 心血管疾病。 我们通常用身体成分指标, 如身体质量指数 (BMI), 体脂百分比 (BFP), 腰高比 (WHtR) 和腰臀比 (WHR) 反映肥胖程度。 本文通过对中国成人的横断面研究揭示身体成分指标和代谢参数之间的关系。
方法: 研究对象包括12018中国成年人. 身体成分指标包括: BMI, BFP, WHtR, WHR。 代谢参数包括: 收缩压 (SBP), 舒张压 (DBP), 总胆固醇 (TC), 甘油三酯 (TG), 低密度脂蛋白胆固醇 (LDL-C), 高密度脂蛋白胆固醇 (HDL-C), 空腹血糖 (FBG), 餐后2 h血糖 (2h PBG), 糖化血红蛋白 (HbA1c), 空腹胰岛素 (FINS), 胰岛素抵抗指数 (HOMA-IR), 高敏c反应蛋白 (hs-CRP), 和白细胞计数 (WBC)。 所有分析都按性别分层。
结果: 中国成年男性和女性相比, 除了2h PBG外, 所有身体成分指标及代谢参数之间存在显著统计学差异 (P < 0.001)。 BMI (WHtR, WHR) 与SBP, DBP, LDL-C, TC, TG, FBG, 2h PBG, HbA1c, FINS, HOMA-IR, hs-CRP 和WBC呈正相关, 与高密度脂蛋白胆固醇呈负相关。 多变量分析显示男性中, 以 BMI 为分组标准, 超重组的葡萄糖调节受损 (IGR), 血脂异常, 胰岛素抵抗和升高的高敏c反应蛋白 (hs-CRP) 分别为正常体重组的 1.36, 1.92, 3.44, 和 1.27 倍; 肥胖组分别为正常组的 1.66, 3.26, 7.53, 和 1.70 倍。 以BFP 为分组标准, BFP ≥28.0%组血脂异常, hs-CRP 异常的比例分别是 BFP <28.0% 组的 1.29 和 1.38 倍。 以 WHtR 为分组标准, WHtR ≥ 0.96 组血脂异常, HOMA-IR, hs-CRP 分别是 WHtR < 0.96 组的 1.55, 1.26, 和 1.48 倍。 以WHR为分组标准, WHR ≥0.54 组HOMA-IR是 WHR <0.54 组的 1.46 倍。 在女性中也观察到类似的结果。
结论: 本研究发现在中国成年人中身体成分指标和代谢参数之间存在正相关。 在不同性别中, 身体成分指标 BMI 可以预测五个代谢紊乱参数中的四个。