Transition of Hypertriglyceridemic-Waist Phenotypes and the Risk of Type 2 Diabetes Mellitus among Middle-Aged and Older Chinese: A National Cohort Study

Abstract

The rapid economic growth and nutritional changes in China have brought an increased burden of type 2 diabetes mellitus (T2DM). This study aimed to assess the effects of hypertriglyceridemic-waist (HTW) and its dynamic transitions on incident T2DM among middle-aged and older Chinese. Data were extracted from the China Health and Retirement Longitudinal Study (CHARLS). Participants were classified into three HTW phenotypes, namely NTNW (normal triglyceride (TG) and waist circumference (WC)), NTEW/ETNW (normal TG and enlarged WC, or elevated TG and normal WC) and ETEW (elevated TG and enlarged WC). Multivariable Cox frailty models were used to assess the associations of HTW phenotypes and their transitions over time with the risk of T2DM. A total of 7397 subjects without T2DM were included, of which 849 developed T2DM during 2011–2018. Compared with individuals with NTNW, people in the NTEW/ETNW group and ETEW group were at a significantly higher risk of T2DM (HRNTEW/ETNW = 1.28, 95% CI: 1.06–1.54 and HRETEW = 1.61, 95% CI: 1.26–2.06). For subjects with NTNW at baseline, the risk of developing T2DM increased by 38% and 83% if their metabolic status changed to NTEW/ETNW and ETEW, respectively. For subjects with NTEW/ETNW, the risk of T2DM decreased by 33% when their metabolic status changed to normal (NTNW); but the risk increased by 49% if the status became more serious (ETEW). NTEW/ETNW, ETEW and their transitions to adverse states were risk factors for T2DM.

Childhood Socioeconomic Status and Late-Adulthood Health Outcomes in China: A Life-Course Perspective

“…This excludes 57 individuals from the analysis (0.35% of the total). The percentage overweight is higher than that in the study using CHARLS wave 1 in China (37.6%) (Chen et al, 2021) but consistent with studies using ELSA (41.4%) (Jackson et al, 2015(Jackson et al, , 2017 and HRS (40.7%) with a broadly similarly-aged cohort of people (Feinglass et al, 2007). However, the proportion of obesity (6%) is much lower than those using data from ELSA and HRS (31% and 21.9%, respectively) (Feinglass et al, 2007;Jackson et al, 2015Jackson et al, , 2017.…”

Cardiorespiratory fitness and metabolic risk in Chinese population: evidence from a prospective cohort study

“…The China Health and Retirement Longitudinal Study (CHARLS) is a longitudinal cohort study recruiting a nationally representative sample of individuals aged ≥ 45 years from 150 counties of 28 provinces in China [ 27 ]. CHARLS was conducted for five rounds (2011, 2013, 2014, 2015, and 2018), among which the 2011 (baseline) and 2015 rounds provided biomarker data, and the 2014 round was the Life History Survey [ 28 ]. Details of the sampling method and data collection are reported elsewhere [ 27 ].…”

“…Ethical approval for the study was granted by the Ethical Review Committee of Peking University and was conducted by the National School for Development (China Centre for Economic Research) at Peking University, following the Helsinki guidelines. The Institutional Review Board (IRB) approval number for the main household survey, including anthropometrics, was IRB00001052-11015, and the IRB approval number for biomarker collection was IRB00001052-11014 [ 28 ]. Informed consent was obtained from all participants involved in the CHARLS, and all participants signed written informed consent forms.…”

Triglyceridemic Waist Phenotypes as Risk Factors for Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis

“…507 manuscripts were found in the database search. After removing the duplicates, which were 256, we reviewed 251 records, of which we reviewed fulltext documents of 44 of them, to finally include 7 articles [11][12][13][14][20][21][22]. No additional articles were found.…”