A retrospective cohort study of different obesity evaluation indicators predicting the risk of hypertension-diabetes comorbidities(HDC)
Objective To analyze the predictive value of different obesity indicators for the risk of hyperten-sion and diabetes comorbidity(HDC),and to provide scientific basis for the primary prevention of HDC.Methods The residents of 2018-2022 Hotan survey site of"Xinjiang multi-ethnic natural population co-hort construction and health follow-up study"were used as study subjects,and Cox proportional risk re-gression model was used to analyze the general obesity indicators:body mass index(BMI),central obesity indicators:waist circumference(WC),waist-to-height ratio(WHTR),conicity Index(CI),comprehen-sive obesity indicators:weight-adjusted waist circumference index(WWI),body shape index(ABSI),and the risk of HDC,and analyzed the predictive effect of different obesity indicators on the incidence of HDC by using subject work characteristics(ROC)curves.Results A total of 12 679 study subjects were en-rolled at baseline,with a cumulative follow-up of 57 629.4 person-years,and a total of 661 new cases of HDC were reported,with an incidence density of 11.47 per 1 000 person-years.After adjusting for rele-vant confounders,the results of the Cox proportional analysis regression model showed that the risk of HDC was increased with the elevation of obesity indicators(P＜0.01).The risk of HDC incidence in the overweight and obese subgroups of BMI was 1.63 and 3.40 times higher than that of normal group of BMI,respectively,and the risk of HDC incidence in the group of WC overweight was 2.74 times higher than that of group of WC normal.The risk of HDC in patients with elevated WHTR was 2.48 times higher than that in patients with normal WHTR.The risk of HDC incidence in the quartile groups of WWI,CI and ABSI quartile grouping Q4 group had 3.02,3.78 and 1.87 times higher risk of HDC incidence than the Q1 group,respectively.The results of the ROC curve analysis showed that the top 3 AUC values were all central obesity indicators.The AUC of WC,WHTR and CI for predicting HDC were 0.685(95％CI:0.676～0.694),0.673(95％CI:0.664～0.682)and 0.666(95％CI:0.657～0.675),respectively.The Youden index and specificity of central obesity index were higher than those of other obesity indexes,and the sensitivity of the new comprehensive obesity index was higher than that of other obesity indexes.De-long test results showed that the AUC values of WC and WHTR predicting the risk of HDC were higher than BMI,ABSI(P＜0.003).There were no significant differences in AUC values between BMI and CI,WWI,ABSI,WC and WHTR,CI,WWI,WHTR and CI,CI and WWI.Conclusion BMI,WC,WHTR,WWI,CI and ABSI were associated with increased risk of HDC,central obesity indicators can better predict the risk of HDC.
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