The Association Of Different Obesity Indictors And Newly Diagnosed Type 2 Diabetes Mellitus In Qingdao Adults

Background and Objectives:Obesity and type 2 diabetes mellitus(T2DM)are long term disorder of metabolism,affected by genetic,environmental,social,economic,cultural and lifestyle factors.They have become important public health problem affecting the health of global residents.Body mass index(BMI),waist circumference(WC),waist to hip ratio(WHR)and waist to height ratio(WHtR)are common indicators reflecting the level of obesity,although there have been some studies on the association between obesity indictors and newly diagnosed T2DM,the results are inconsistent.Therefore,this study intends to investigate the association between different obesity indictors and risk of T2DM prevalence,and further explore whether different obesity indictors can be used as a simple tool for screening of the newly diagnosed T2DM,and discuss the internal molecular biology mechanism of obesity and T2DM.It provides a more accurate theoretical basis for the prevention and treatment of obesity and T2DM.Methods:A cross-sectional study was used to analysis the association between different obesity indictors and newly diagnosed T2DM.A four-stage random sampling method was used to recruit a general population representative of 12 100 citizens lived more than 5years and aged 35?74 years in 7 districts and 5 cities of Qingdao.A total of 10 465individuals were initially enrolled in this study.In this study,we had used strict exclusion criteria:diagnosed T2DM,and no data of BMI,WC,WHR,WHtR,fasting plasma glucose(FPG)and 2 hours post-load plasma glucose(2h PG).A total of 7 671 individuals who met the strict exclusion criteria were included for the final analysis.Pearson correlation and multivariate linear regression analysis were used to analyze the correlation between BMI,WC,WHR,WHtR and FPG,2hPG.Multivariable logistic regression analysis was used to analyze the association between different obesity indictors and the prevalence of newly diagnosed T2DM.Then we used Receiver operating characteristic curve(ROC curve)to analyze different obesity indictors screening of newly diagnosed T2DM prevalence.We used bioinformatics study to investigate the internal molecular mechanism of obesity,abdominal obesity and T2DM.With the help of GEO Datasets,we obtained the genes related to T2DM,obesity and abdominal obesity,and analyze the differentially expressed genes(DEGs).Finally,we perform gene function enrichment analysis with gene ontology(GO)and KEGG pathway on DEGs of obesity,abdominal obesity and T2DM by DAVID online software.Results:The cross-sectional study showed that the prevalence of newly diagnosed T2DM was on the rise with the increase of BMI,WC,WHR and WHtR in the general and men population,(P<0.001).However,the prevalence of newly diagnosed T2DM in low body weight group was higher than that in normal group in women population(P<0.001).Pearson correlation analysis and Multivariate linear regression analysis illustrated that BMI,WC,WHR and WHtR levels were positively correlated with FPG and 2h PG(P<0.001).When adjusted related confounding factors.Multivariate logistic regression analysis showed that the risk of newly diagnosed T2DM was higher in the overweight group,obesity group,and abdominal obesity group according to WC,WHR and WHtR than that in the normal group in the general and women population.The odds ratio(OR)and 95%confidence intervals(CI)were 1.35(1.12,1.62),2.05(1.67,2.51),1.59(1.35,1.87),1.42(1.22,1.65),1.49(1.26,1.75)in the general and 1.48(1.14,1.93),2.13(1.61,2.81),1.61(1.27,2.03),1.59(1.28,1.97),1.66(1.30,2.13)in women population,respectively.The risk of newly diagnosed T2DM in the obesity group and in the abdominal obesity according to WC was higher than that in the normal group,OR and 95%CI were 1.86(1.38,2.53)and 1.47(1.17,1.85),respectively,while the risk of newly diagnosed T2DM in the abdominal obesity according to WHR and WHtR was not statistically significant higher than that in the normal group in men population(P>0.05).The optimal cut-of values for screening of newly diagnosed T2DM were The optimal cut-of values for screening of newly diagnosed T2DM were BMI>25.57 kg/m~2,WC>84.30 cm,WHR>0.84and WHtR>0.52,respectively,in the general.BMI>25.73 kg/m~2,WC>84.80 cm,WHR>0.91 and WHtR>0.52,respectively,in the men population.BMI>25.55 kg/m~2,WC>85.80 cm,WHR>0.84 and WHtR>0.52,respectively,in the women population.The optimal obesity index for screening newly diagnosed T2DM was WHtR(P<0.05),and the optimal cut-of values was WHtR>0.52.According to GEO database analysis,there are 150 DEGs associated with T2DM and obesity,146 DEGs associated with T2DM and abdominal obesity.Go analysis showed that the common DEGs of obesity,abdominal obesity and T2DM were mainly involved in extracellular exosomes,focal adhesion,protein binding,actin binding and other cell components or molecular functions.Conclusions:The prevalence of newly diagnosed T2DM increased with the levels of BMI,WC,WHR and WHtR and they were positively correlated with blood glucose level.The risk of newly diagnosed T2DM increased with the levels of BMI,WC,WHR and WHtR in the general and women population.However,low accuracy for screening newly diagnosed T2DM were found in all indicators of obesity in both genders.Obesity and abdominal obesity may be related to T2DM through cell components such as extracellular exosomes,focal adhesion and molecular functions such as protein binding and actin binding.