李淑红
中国医学科学院阜外医院 营养室
BACKGROUND:Little is known about the relationship between dietary intake of choline, which is a major dietary precursor for gut microbiome-derived trimethylamine N-oxide (TMAO), and diabetes mellitus (DM) in the general population. The present study aims to explore the relationship between dietary choline intake and DM in the US adult population.METHODS:Cross-sectional data were derived from the National Health and Nutrition Examination Survey (NHANES) 2007-2010 of 8621 individuals aged 20 years or older. Multivariable logistic regression models were used to determine odds ratios (ORs) and 95% confidence intervals (CIs) for DM of each quartile category of energy-adjusted choline intakes. The restricted cubic spline model was used for the dose-response analysis. The receiver operating characteristic (ROC) curve was used to determine the optimal cutoff value of choline intake for predicting DM.RESULTS:A linear dose-response relationship between dietary choline intake and the odds of DM was found after adjustment for multiple potential confounding factors. With the lowest quartile category of choline as the reference, the multivariable-adjusted ORs and 95% CIs of the second, third, and highest quartile categories were 1.23 (0.99-1.53), 1.27 (1.02-1.58), and 1.49 (1.20-1.85), respectively, P for trend =0.0004. The ROC analysis identified energy-adjusted choline of 331.7 mg/8.37-MJ per day as the optimal cutoff value for predicting DM, with 52.5% sensitivity and 60.7% specificity.CONCLUSION:This study supports a positive and linear relationship between dietary choline intake and DM in the US adult population.
Journal of diabetes 2021
OBJECTIVE:To study the efficacy of waist circumference (WC) and waist-to-height ratio (WHtR) in predicting central obesity among the Chinese adult population.METHODS:A total of 30 630 participants aged 35 - 59 from different areas in mainland China were surveyed for the risk factors of cardiovascular diseases (CVD) in two independent cross-sectional studies that were carried out in 1992 - 1994 and 1998, respectively. In subgroups with different heights, consistency analysis for central obesity diagnosed by WHtR (≥ 0.50) and WC (≥ 85 cm for men, ≥ 80 cm for women) were conducted. Sensitivity and specificity for predicting the clustering of risk factors (number ≥ 2) would include hypertension, abnormal glucose, high serum total cholesterol and low serum high density lipoprotein cholesterol and they were also calculated to evaluate the efficacy of prediction, with the two indices in the different height subgroups as well.RESULTS:The consistency of diagnosis on central obesity by WC and WHtR was good in the whole population (the Kappa value was 0.805 in men and 0.816 in women), but poor (all Kappa values ≤ 0.6) for those with tall (men's height ≥ 180 cm and women's height ≥ 170 cm) or with short statures (men's height < 160 cm, and women's height < 150 cm). Sensitivity in the shorty subgroups and specificity in the tall subgroups appeared poor in both genders, by using WC criteria to predict the clustering of risk factors. However, the sensitivity (ranged from 56.1% to 64.1% for men and 64.7% to 73.2% for women) and specificity (from 70.0% to 74.5% for men, 59.2% to 75.9% for women) seemed good and stable in all the subgroups as well as in both genders by using the WHtR criteria.CONCLUSION:WC and WHtR could both be applied in predicting the clustering of risk factors of CVD and in evaluating the central obesity in the whole population. With satisfactory efficacy, WHtR seemed to be better than WC in the prediction of central obesity, both in men or women with tall or short statures.
Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi 2013
