Associations of obesity-related indices with prediabetes regression to normoglycemia among Chinese middle-aged and older adults: a prospective study

Hongguang Yang; Minjie Zhang; Jiaqi Nie; Minzhe Zhang; Gaolei Lu; Rui Chen; Qiqiang He

doi:10.3389/fnut.2023.1075225

Associations of obesity-related indices with prediabetes regression to normoglycemia among Chinese middle-aged and older adults: a prospective study

Front Nutr. 2023 May 19:10:1075225. doi: 10.3389/fnut.2023.1075225. eCollection 2023.

Authors

Hongguang Yang¹, Minjie Zhang¹, Jiaqi Nie¹, Minzhe Zhang¹, Gaolei Lu¹, Rui Chen¹, Qiqiang He^{1

2}

Affiliations

¹ School of Public Health, Wuhan University, Wuhan, China.
² Hubei Biomass-Resource Chemistry and Environmental Biotechnology Key Laboratory, Wuhan University, Wuhan, China.

Abstract

Background: Prediabetes is associated with increased cardiovascular risk and all-cause mortality, while its regression will decrease the risks. This study investigated the associations of six obesity-related indices (waist-to-height ratio (WHtR), body roundness index (BRI), conicity index (CI), body shape index (ABSI), Chinese visceral adiposity index (CVAI), and triglyceride glucose (TyG) index) with prediabetes regression based on the China Health and Retirement Longitudinal Study (CHARLS), enrolling middle-aged and older adults.

Methods: We included 2,601 participants with prediabetes from CHARLS, who were followed up from 2011-2012 to 2015-2016, with blood samples collected for measuring fasting plasma glucose and hemoglobin A1c. All the obesity-related indices at baseline and their dynamic changes were calculated and categorized into tertiles. Logistic regression analysis was applied to obtain the odds ratio (OR) and 95% confidence intervals (CIs). Attributable fractions (AFs) and 95% CIs of these indices and the dynamic changes were calculated with the AF package in R software, and the cutoff values of initial obesity-related indices were obtained by the receiver operating characteristic (ROC) analysis.

Results: During the 4-year follow-up period, 562 (21.61%) participants regressed from prediabetes to normoglycemia. They had lower initial BRI, WHtR, CI, ABSI, CVAI, and TyG than those who did not (P < 0.05). After multivariable adjustment, participants in the first tertile of initial BRI (OR, 1.45, 95%CIs, 1.09-1.93), WHtR (OR, 1.46, 95%CIs, 1.10-1.95), and CVAI (OR, 1.47, 95%CIs, 1.11-1.93) had increased odds of prediabetes regression compared with those in the highest tertile. Participants with decreased TyG (OR, 2.08; 95%CIs, 1.61-2.70) also had increased odds of prediabetes regression compared with those with increased TyG. The cutoff values of initial obesity-related indices were 4.374 for BRI, 0.568 for WHtR, 8.621 for TyG, 1.320 for CI, 0.083 for ABSI, and 106.152 for CVAI, respectively. The AFs were 21.10% for BRI < 4.374, 20.85% for WHtR < 0.568, 17.48% for CVAI < 107.794, and 17.55% for ΔTyG < 0, respectively.

Conclusion: Low initial BRI, WHtR, and CVAI, as well as TyG reduction, were significantly related to prediabetes regression to normoglycemia, and the AFs were around 20%. Less abdominal fat and insulin resistance reduction would benefit future health outcomes among people with prediabetes.

Keywords: abdominal fat; insulin resistance; obesity; obesity-related indices; prediabetes regression.

Grants and funding

This study was supported by the Funding of Wuhan University-Duke Kunshan University Joint Research Platform (WHUDKUZZJJ202203) and the China-Australia Research Cooperation and High-level Talents Training Program in Nutrition and Health Research, China Scholarship Council (2022-No. 1007).