Triglyceridemic Waist Phenotypes as Risk Factors for Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis
DOI:
https://doi.org/10.6000/1929-6029.2024.13.03Keywords:
Diabetes mellitus, triglycerides, waist circumference, hypertriglyceridemic waist, systematic review (source: MeSH NLM)Abstract
Introduction: Triglyceride waist phenotypes, which combine high triglyceride levels and central obesity, have recently emerged as an area of interest in metabolic disease research.
Objective: To conduct a systematic review (SR) with meta-analysis to determine if triglyceride waist phenotypes are a risk factor for T2DM.
Materials: SR with meta-analysis of cohort studies. The search was conducted in four databases: PubMed/Medline, Scopus, Web of Science, and EMBASE. Participants were classified into four groups, based on triglyceride level and waist circumference (WC): 1) Normal WC and normalConduct triglyceride level (NWNT); 2) Normal WC and high triglyceride level (NWHT), 3) Altered WC and normal triglyceride level (EWNT) and 4) Altered WC and high triglyceride level (EWHT). For the meta-analysis, only studies whose measure of association were presented as Hazard ratio (HR) along with 95% confidence intervals (CI95%) were used.
Results: Compared to people with NWHT, a statistically significant association was found for those with NWHT (HR: 2.65; CI95% 1.77–3.95), EWNT (HR: 2.54; CI95% 2.05–3.16) and EWHT (HR: 4.41; CI95% 2.82–6.89).
Conclusions: There is a clear association between triglyceride waist phenotypes and diabetes, according to this SR and meta-analysis. Although central obesity and high triglyceride levels are associated with a higher risk of the aforementioned disease, their combination appears to pose an even greater risk. Therefore, in the clinical setting, it is important to consider this when assessing the risk of diabetes.
References
Diabetes Canada Clinical Practice Guidelines Expert Committee, Punthakee Z, Goldenberg R, Katz P. Definition, Classification and Diagnosis of Diabetes, Prediabetes and Metabolic Syndrome. Can J Diabetes 2018; 42(Suppl 1): S10-5. https://doi.org/10.1016/j.jcjd.2017.10.003 DOI: https://doi.org/10.1016/j.jcjd.2017.10.003
Ruze R, Liu T, Zou X, Song J, Chen Y, Xu R, et al. Obesity and type 2 diabetes mellitus: connections in epidemiology, pathogenesis, and treatments. Front Endocrinol (Lausanne). 2023; 14: 1161521. https://doi.org/10.3389/fendo.2023.1161521 DOI: https://doi.org/10.3389/fendo.2023.1161521
National Diabetes Statistics Report | Data & Statistics | Diabetes | CDC [Internet]. 2020 [citado el 19 de febrero de 2020]. Disponible en: https://www.cdc.gov/diabetes/data/ statistics/statistics-report.html
Home, Resources, diabetes L with, Acknowledgement, FAQs, Contact, et al. Resources | IDF Diabetes Atlas [Internet]. [citado el 19 de junio de 2022]. Disponible en: https://diabetesatlas.org/resources/
Wang L, Gao P, Zhang M, Huang Z, Zhang D, Deng Q, et al. Prevalence and Ethnic Pattern of Diabetes and Prediabetes in China in 2013. JAMA 2017; 317(24): 2515-23. https://doi.org/10.1001/jama.2017.7596 DOI: https://doi.org/10.1001/jama.2017.7596
Lopez Stewart G, Tambascia M, Rosas Guzmán J, Etchegoyen F, Ortega Carrión J, Artemenko S. Control of type 2 diabetes mellitus among general practitioners in private practice in nine countries of Latin America. Rev Panam Salud Publica 2007; 22(1): 12-20. https://doi.org/10.1590/S1020-49892007000600002 DOI: https://doi.org/10.1590/S1020-49892007000600002
Barreiro-Ribeiro F, Junqueira VC, Cassia da S de, Porto Z, Bernardi RMD, Fernandes C, et al. Hypertriglyceridemic Waist Phenotype Indicates Insulin Resistance in Adolescents According to the Clamp Technique in the BRAMS Study. Childhood Obesity 2016. https://doi.org/10.1089/chi.2016.0180 DOI: https://doi.org/10.1089/chi.2016.0180
Gamonal JMR, Palomino RM, Zuzunaga-Montoya FE, Torres-Malca JR, Gonzalez AJC, Vera-Ponce VJ, et al. Cintura hipertrigliceridémica e hipertensión arterial en adultos: una revisión sistemática y metaanálisis: Hypertriglyceridemic waist and arterial hypertension in adults: a systematic review and meta-analysis. Revista de la Facultad de Medicina Humana [Internet]. 2022 [citado el 31 de marzo de 2023]; 22(4). https://doi.org/10.25176/RFMH.v22i4.5092 DOI: https://doi.org/10.25176/RFMH.v22i4.5092
Guo Y-Y, Li H-X, Zhang Y, He W-H. Hypertriglyceridemia-induced acute pancreatitis: progress on disease mechanisms and treatment modalities. Discov Med 2019; 27(147): 101-9. https://doi.org/10.3390/ijerph13040368
Chen S, Guo X, Yu S, Sun G, Li Z, Sun Y. Association between the Hypertriglyceridemic Waist Phenotype, Prediabetes, and Diabetes Mellitus in Rural Chinese Population: A Cross-Sectional Study. Int J Environ Res Public Health 2016; 13(4): 368. DOI: https://doi.org/10.3390/ijerph13040368
Zhang M, Gao Y, Chang H, Wang X, Liu D, Zhu Z, et al. Hypertriglyceridemic-waist phenotype predicts diabetes: a cohort study in Chinese urban adults. BMC Public Health 2012; 12: 1081. https://doi.org/10.1186/1471-2458-12-1081 DOI: https://doi.org/10.1186/1471-2458-12-1081
Xu M, Huang M, Qiang D, Gu J, Li Y, Pan Y, et al. Hypertriglyceridemic Waist Phenotype and Lipid Accumulation Product: Two Comprehensive Obese Indicators of Waist Circumference and Triglyceride to Predict Type 2 Diabetes Mellitus in Chinese Population. J Diabetes Res 2020; 2020: 9157430. https://doi.org/10.1155/2020/9157430 DOI: https://doi.org/10.1155/2020/9157430
Janghorbani M, Amini M. Utility of hypertriglyceridemic waist phenotype for predicting incident type 2 diabetes: The Isfahan Diabetes Prevention Study. J Diabetes Investig. 2016; 7(6): 860-6. https://doi.org/10.1111/jdi.12520 DOI: https://doi.org/10.1111/jdi.12520
Han KJ, Lee SY, Kim NH, Chae HB, Lee TH, Jang CM, et al. Increased risk of diabetes development in subjects with the hypertriglyceridemic waist phenotype: a 4-year longitudinal study. Endocrinol Metab (Seoul) 2014; 29(4): 514-21. https://doi.org/10.3803/EnM.2014.29.4.514 DOI: https://doi.org/10.3803/EnM.2014.29.4.514
Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009; 6(7): e1000097. https://doi.org/10.1371/journal.pmed.1000097 DOI: https://doi.org/10.1371/journal.pmed.1000097
American Diabetes Association. Standards of Medical Care in Diabetes—2022 Abridged for Primary Care Providers. Clinical Diabetes 2022; 40(1): 10-38. https://doi.org/10.2337/cd22-as01 DOI: https://doi.org/10.2337/cd22-as01
Ottawa Hospital Research Institute [Internet]. [citado el 11 de julio de 2022]. Disponible en: https://www.ohri.ca/programs/ clinical_epidemiology/oxford.asp
Higgins JPT, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med 2002; 21(11): 1539-58. https://doi.org/10.1002/sim.1186 DOI: https://doi.org/10.1002/sim.1186
Cochrane Handbook for Systematic Reviews of Interventions [Internet]. [citado el 27 de noviembre de 2021]. Disponible en: https://training.cochrane.org/handbook
Chen D, Liang Z, Sun H, Lu C, Chen W, Wang HHX, et al. Association between Hypertriglyceridemic-Waist Phenotype and Risk of Type 2 Diabetes Mellitus in Middle-Aged and Older Chinese Population: A Longitudinal Cohort Study. Int J Environ Res Public Health 2021; 18(18): 9618. https://doi.org/10.3390/ijerph18189618 DOI: https://doi.org/10.3390/ijerph18189618
Chen G, Yi Q, Hou L, Peng S, Fan M, Song P, et al. Transition of Hypertriglyceridemic-Waist Phenotypes and the Risk of Type 2 Diabetes Mellitus among Middle-Aged and Older Chinese: A National Cohort Study. Int J Environ Res Public Health 2021; 18(7): 3664. https://doi.org/10.3390/ijerph18073664 DOI: https://doi.org/10.3390/ijerph18073664
He S, Zheng Y, Shu Y, He J, Wang Y, Chen X. Hypertriglyceridemic waist might be an alternative to metabolic syndrome for predicting future diabetes mellitus. PLoS One 2013; 8(9): e73292. https://doi.org/10.1371/journal.pone.0073292 DOI: https://doi.org/10.1371/journal.pone.0073292
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA 2001; 285(19): 2486-97. https://doi.org/10.1001/jama.285.19.2486 DOI: https://doi.org/10.1001/jama.285.19.2486
Hsu WC, Araneta MRG, Kanaya AM, Chiang JL, Fujimoto W. BMI Cut Points to Identify At-Risk Asian Americans for Type 2 Diabetes Screening. Diabetes Care 2015; 38(1): 150-8. https://doi.org/10.2337/dc14-2391 DOI: https://doi.org/10.2337/dc14-2391
Bao Y, Lu J, Wang C, Yang M, Li H, Zhang X, et al. Optimal waist circumference cutoffs for abdominal obesity in Chinese. Atherosclerosis 2008; 201(2): 378-84. https://doi.org/10.1016/j.atherosclerosis.2008.03.001 DOI: https://doi.org/10.1016/j.atherosclerosis.2008.03.001
Lee JJ, Beretvas SN, Freeland-Graves JH. Abdominal Adiposity Distribution in Diabetic/Prediabetic and Nondiabetic Populations: A Meta-Analysis. J Obes 2014; 2014: 697264. https://doi.org/10.1155/2014/697264 DOI: https://doi.org/10.1155/2014/697264
Sam S, Haffner S, Davidson MH, D’Agostino RB, Feinstein S, Kondos G, et al. Relationship of Abdominal Visceral and Subcutaneous Adipose Tissue With Lipoprotein Particle Number and Size in Type 2 Diabetes. Diabetes 2008; 57(8): 2022-7. https://doi.org/10.2337/db08-0157 DOI: https://doi.org/10.2337/db08-0157
Harchaoui KEL, Visser ME, Kastelein JJP, Stroes ES, Dallinga-Thie GM. Triglycerides and Cardiovascular Risk. Curr Cardiol Rev 2009; 5(3): 216-22. https://doi.org/10.2174/157340309788970315 DOI: https://doi.org/10.2174/157340309788970315
Nordestgaard BG, Varbo A. Triglycerides and cardiovascular disease. Lancet 2014; 384(9943): 626-35. https://doi.org/10.1016/S0140-6736(14)61177-6 DOI: https://doi.org/10.1016/S0140-6736(14)61177-6
Ouchi N, Parker JL, Lugus JJ, Walsh K. Adipokines in inflammation and metabolic disease. Nat Rev Immunol 2011; 11(2): 85-97. https://doi.org/10.1038/nri2921 DOI: https://doi.org/10.1038/nri2921
Vasamsetti SB, Natarajan N, Sadaf S, Florentin J, Dutta P. Regulation of cardiovascular health and disease by visceral adipose tissue-derived metabolic hormones. J Physiol 2023; 601(11): 2099-120. https://doi.org/10.1113/JP282728 DOI: https://doi.org/10.1113/JP282728
Gao M, Cui D, Xie J. The role of adiponectin for immune cell function in metabolic diseases. Diabetes Obes Metab 2023. https://doi.org/10.1111/dom.15151 DOI: https://doi.org/10.1111/dom.15151
Zlobine I, Gopal K, Ussher JR. Lipotoxicity in obesity and diabetes-related cardiac dysfunction. Biochim Biophys Acta. 2016; 1861(10): 1555-68. https://doi.org/10.1016/j.bbalip.2016.02.011 DOI: https://doi.org/10.1016/j.bbalip.2016.02.011
Marušić M, Paić M, Knobloch M, Liberati Pršo A-M. NAFLD, Insulin Resistance, and Diabetes Mellitus Type 2. Can J Gastroenterol Hepatol 2021; 2021: 6613827. https://doi.org/10.1155/2021/6613827 DOI: https://doi.org/10.1155/2021/6613827
Weir GC. Glucolipotoxicity, β-Cells, and Diabetes: The Emperor Has No Clothes. Diabetes 2020; 69(3): 273-8. https://doi.org/10.2337/db19-0138 DOI: https://doi.org/10.2337/db19-0138
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Policy for Journals/Articles with Open Access
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are permitted and encouraged to post links to their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work
Policy for Journals / Manuscript with Paid Access
Authors who publish with this journal agree to the following terms:
- Publisher retain copyright .
- Authors are permitted and encouraged to post links to their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work .
