Neck circumference as a risk factor of screen-detected diabetes mellitus: community-based study

Diabetology & Metabolic Syndrome - Tập 8 - Trang 1-8 - 2016
Mykolay Khalangot1,2, Vitaliy Gurianov3, Nadia Okhrimenko2, Igor Luzanchuk2, Victor Kravchenko2
1Shupyk National Medical Academy of Postgraduate Education, Kiev, Ukraine
2Komisarenko Institute of Endocrinology and Metabolism, Kiev, Ukraine
3Bohomolets National Medical University, Kiev, Ukraine

Tóm tắt

Whereas an increase of neck circumference (NC) had been recently identified as a new independent cardiovascular disease (CVD) and metabolic syndrome risk factor, similar assessments concerning screen-detected diabetes mellitus (SDDM) have not been made. Thyroid gland volume (ThV) can potentially affect NC however the significance of this influence concerning the risk of NC-related disease is unknown. We performed a ThV-adjusted evaluation of NC within a population-based investigation of SDDM and impaired glucose regulation (IGR) prevalence. This study contains fasting plasma glucose (FPG) and 75 g 2-h glucose tolerance test results (2-hPG) of 196 residents of Kyiv region, Ukraine, randomly selected from the rural population older than 44 y.o. who were not registered as diabetes mellitus patients. Standard anthropometric (height; weight; blood pressure; waist, hip circumferences), NC and ultrasonography ThV measurements were performed, hypotensive medication, CVD events and early life nutrition history considered. HbA1c was measured, if FPG/2-hPG reached 7.0/11.1 mmol/l respectively; HbA1c level 6.5 % was considered to be SDDM diagnostic; IGR if FPG/2-hPG reached 6.1/7.8 but less than 7.0/11.1 mmol/l respectively. Neck circumference among women with normal FPG/2-hPG was 35 (33–36) cm, IGR 36 (34.5–38) cm, SDDM HbA1c < 6.5 % 42 (40–43) cm, HbA1c > 6.5 % 42.5 (40–44) cm, p < 0.001, and for men from the same groups 38.5 (36.5–41.5) cm; 39 (37–42) cm; 42 (40–43) cm; 42.5 (40–44) cm, p = 0.063; medians (QI–QIII). Gender-adjusted logistic regression OR for SDDM HbA1c > 6.5 % vs. normal FPG/2-hPG category depending of NC as a continued variable, equaled to 1.60 (95 % CI 1.27–2.02) per cm. Additional adjusting by ThV, body mass or waist/hip index, high blood pressure, acute CVD events, or starvation history did not significantly influence this risk. Neck circumference is a new risk factor of SDDM that is independent from other indicators of adipose tissue distribution as well as from the ThV.

Tài liệu tham khảo

Vague J. The degree of masculine differentiation of obesities: a factor determining predisposition of diabetes, atherosclerosis, gout, and uric calculous disease. Am J Clin Nutr. 1956;4:20–34. Hartz AJ, Rupley DC, Rimm AA. The association of girth measurements with disease in 32,856 women. Am J Epidemiol. 1984;119:71–80. Freedman DS, Rimm AA. The relation of body fat distribution, as assessed by six girth measurements, to diabetes mellitus in women. Am J Public Health. 1989;79(6):715–20. Alberti KGMM, Zimmet P, Shaw J. Metabolic syndrome—a new world-wide definition. A consensus statement from the international diabetes federation. Diabet Med. 2006;23(5):469–80. Pouliot MC, Després JP, Lemieux S, Moorjani S, Bouchard C, Tremblay A, Lupien PJ. Waist circumference and abdominal sagittal diameter: best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women. Am J Cardiol. 1994;73(7):460–8. Cizza G, Piaggi P, Lucassen EA, de Jonge L, Walter M, et al. Obstructive sleep apnea is a predictor of abnormal glucose metabolism in chronically sleep deprived obese adults. PLoS ONE. 2013;8(5):e65400. Preis SR, Massaro JM, Hoffmann U, D’Agostino RB Sr, Levy D, Robins SJ, Fox CS. Neck circumference as a novel measure of cardiometabolic risk: the Framingham Heart study. J Clin Endocrinol Metab. 2010;95(8):3701–10. Stabe C, Vasques ACJ, Lima MMO, Tambascia MA, Pareja JC, Yamanaka A, Geloneze B. Neck circumference as a simple tool for identifying the metabolic syndrome and insulin resistance: results from the Brazilian metabolic syndrome study. Clin Endocrinol. 2013;78(6):874–81. Zhou JY, Ge H, Zhu MF, Wang LJ, Chen L, Tan YZ, Zhu HL. Neck circumference as an independent predictive contributor to cardio-metabolic syndrome. Cardiovasc Diabetol. 2013;12(76):10–1186. Cho NH, Oh TJ, Kim KM, Choi SH, Lee JH, Park KS, Lim S. Neck Circumference and Incidence of Diabetes Mellitus over 10 Years in the Korean Genome and Epidemiology Study (KoGES). Sci Rep. 2015. doi:10.1038/srep18565. Khalangot MD, Kravchenko VI, Pisarenko YM, Okhrimenko NV, Lerman NG, Kovtun VA. Prevalence of diabetes mellitus, impaired glucose regulation, and their anthropometric risk factors in elderly residents of rural Ukraine. Endocrynologia. 2014;19(2):119–25. Shai I, Jiang R, Manson JE, Stampfer MJ, Willett WC, Colditz GA, Hu FB. Ethnicity, obesity, and risk of type 2 diabetes in women: a 20-year follow-up study. Diabet Care. 2006;29(7):1585–90. Kurian AK, Cardarelli KM. Racial and ethnic differences in cardiovascular disease risk factors: a systematic review. Ethnicity Dis. 2007;17:143–52. Thurner S, Klimek P, Szell M, Duftschmid G, Endel G, Kautzky-Willer A, Kasper DC. Quantification of excess risk for diabetes for those born in times of hunger, in an entire population of a nation, across a century. Proc Natl Acad Sci. 2013;110(12):4703–7. Vallin J, Meslé F, Adamets S, Pyrozhkov S. A new estimation of Ukrainian losses during the 30s and 40s crises. Popul Stud. 2002;56:249–64. Lumey LH, Khalangot MD, Vaiserman AM. Association between type 2 diabetes and prenatal exposure to the Ukraine famine of 1932–33: a retrospective cohort study. Lancet Diabet Endocrinol. 2015;3(10):787–94. Ukrainian Parliament. Law of Ukraine No 376–V. On the Holodomor of 1932–1933 in Ukraine. 2006. http://www.president.gov.ua/documents/5280.html. Accessed 10 Dec 2013. European Parliament. 2008. Commemoration of the Holodomor, the artificial famine in Ukraine. 1932–1933 ICH Steering Committee. 1998. ICH Harmonized Tripartite Guideline, Statistical Principles for Clinical Trials. Paulweber B, Valensi P, Lindström J, Lalic NM, Greaves CJ, McKee M, Goldfracht M. A European evidence-based guideline for the prevention of type 2 diabetes. Horm Metab Res. 2010;42:S3–36. Brunn J, Block U, Ruf G, Bos L, Kunze W, Seriba PC. Volume trie der schilddruÈssenlappen mittels realtime sonographie. Dtsch Medizinische WochenschR. 1981;106:1338–40. IDF Diabetes Atlas. 6th ed. 2013. p. 35. http://www.idf.org/diabetesatlas. Yang W, Lu J, Weng J, Jia W, Ji L, Xiao J, He J. Prevalence of diabetes among men and women in China. New Engl J Med. 2010;362(12):1090–101. Mamtani MR, Kulkarni HR. Predictive performance of anthropometric indexes of central obesity for the risk of type 2 diabetes. Arch Med Res. 2005;36(5):581–9. Lorenzo C, Serrano-Ríos M, Martínez-Larrad MT, Gonzalez-Villalpando C, Williams K, Gabriel R, Haffner SM. Which obesity index best explains prevalence differences in type 2 diabetes mellitus? Obesity. 2007;15(5):1294–301. Wang XC, Liu H, Huang YY, Sun H, Bu L, Qu S. Head fat is a novel method of measuring metabolic disorder in Chinese obese patients. Lipids Health Dis. 2014;13(1):113. Cizza G, de Jonge L, Piaggi P, Mattingly M, Zhao X, Lucassen E, Csako G. Neck circumference is a predictor of metabolic syndrome and obstructive sleep apnea in short-sleeping obese men and women. Metab Syndr Relat Disord. 2014;12(4):231–41. Vogel M, Blaak E, Goossens G. Moderate hypoxia exposure: a novel strategy to improve glucose metabolism in humans? EMJ Diabet. 2015;3(1):73–9.