The Value Of Waist Circumference, Waist Height Ratio And Lipid Accumulation Index In Predicting New Prediabetes In The Women Over 40 Years Old In Dalian

Objective: To investigate the predictive value of waist circumference,waist height ratio and lipid accumulation index for new onset prediabetes in women over 40 years of age.Methods: The samples were derived from the REACTION study which was held by Chinese Medical Association.The age,sex,history of drug using,the history of smoking and drinking,family history,diet and exercise were collected.The waist circumference(WC),height,weight,heart rate,systolic pressure and diastolic pressure were measured.The fasting blood glucose(FBG),glycosylated hemoglobin(Hb A1c)and blood lipids were measured in the morning fasting state.And 2 hour blood glucose was measured by oral glucose tolerance test(OGTT 2h PG).According to the inclusion and exclusion criteria,a total of 2725 subjects were included,three years later,2486 participants were included in the follow-up study,with a follow-up rate of 91.2%.Eventually there were 2044 subjects whose the follow-up data were complete were included in the study.According to the four quartile of baseline WC,WHt R and LAP,the subjects were divided into four groups.Analyse the difference in prediabetes incidence after 3 years,and then investigate the relationship between the WC,WHt R,LAP and the new onset prediabetes among the women over 40 years old with normal blood glucose by the binary Logistic regression analysis.Finally,analyse and compare the diagnostic value of WC,WHt R and LAP to predict the new onset prediabetes and delimit the suitable cutting points by the ROC curve.The Z test proved that the predictive efficiency of LAP was better than that of WC and WHt R?Results:1.There were 317 subjects developed prediabetes after there years follow-up,the incidence was 15.51%.According to the WC four quartile,the subjects were divided into four groups: Q1,Q2,Q3 and Q4.The incidence rates of the four groups were8.08%,13.64%,18.62% and 20.18% respectively.There was a statistical difference among groups(?2= 32.73,P<0.05).There were statistical differences between group Q1 and Q2,Q3,Q4(?2=7.468,P<0.05;?2= 22.014,P<0.05;?2=28.105,P<0.05);group Q2 and Q3,Q4(?2= 4.833,P<0.05;?2=8.256,P<0.05).However,there was no statistical difference between group Q3 and Q4.Binary Logistic regression analysis showed that WC was a risk factor for new onset prediabetes,after adjusting age,smoking,weight,FBG,LDL-C and BMI(OR = 1.023,95% CI : 1.004-1.042,P<0.05).2.According to the WHt R four quartile,the subjects were divided into four groups: W1,W2,W3 and W4.The prevalence rates of the four groups were 8.66%,13.35%,20.63% and 19.41% respectively.The incidences of four groups was tested by?2 test.The result showed that there were statistical differences among the four groups(?2= 36.133,P<0.05).There were statistical differences between group W1 and group W2,W3,W4(?2=5.733,P<0.05;?2= 29.12,P<0.05;?2=24.36,P<0.05);group W2 and W3,W4(?2= 9.659,P<0.05;?2= 6.903,P<0.05).And there was no statistical difference between group W3 and W4.Binary Logistic regression analysis showed that WHt R was a risk factor for prediabetes,after adjustingage,smoking,weight,FBG,LDL-C and BMI(OR=1.534,95%CI 1.047-2.248,P<0.05).3.According to the LAP four quartile,the subjects were divided into four groups:L1,L2,L3 and L4.The prevalence rates of the four groups were 8.02%,12.18%,17.74% and 24.07% respectively.There were statistical differences between every two groups.Binary Logistic regression analysis showed that LAP was a risk factor for prediabetes,after adjusting age,smoking,weight,FBG,LDL-C and BMI(OR=1.012,95% CI 1.008-1.017,P<0.05).4.ROC curve analysis showed that the AUCs of WC,WHt R and LAP for predicting new prediabetes were 0.598,0.602 and 0.646 respectively.The diagnostic value of WC,WHt R and LAP for new prediabetes were significantly(P<0.05).WC>82.5cm was the best cut-off point for predicting new prediabetes.The sensitivity was 79.8 and the specificity was 39.7.WHt R > 0.55 was the best cut-off point for predicting new prediabetes.The sensitivity was 63.1 and the specificity was 54.3.LAP>34.84 was the best cut-off point for predicting new prediabetes.The sensitivity was 63.4 and the specificity was 60.1.Conclusions:1.WC,WHt R and LAP were independent risk factors for prediabetes in community women.2.The cut-off point of WC,WHt R and LAP for predicting prediabetes were 82.5cm,0.55 and 34.84 respectively.3.Compare with WHt R and WC,LAP shows a better diagnostic value to predict new prediabetes.