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Associations of intermediate hyperglycemia with elevated abdominal obesity, high-sensitivity C-reactive protein, and leptin in Korean adults

  • Received : 2024.05.23
  • Accepted : 2024.08.02
  • Published : 2024.08.31

Abstract

Purpose: This study investigated the associations between intermediate hyperglycemia (IH) and increased body mass index (BMI), abdominal obesity (AO), high-sensitivity C-reactive protein (hs-CRP), and leptin levels in Korean adults. Methods: The participants were 248 adults (≥ 19 years) who understood the purpose of the study, had no cognitive impairment, and were able to communicate. Physical examinations, BMI, AO measurements, and blood tests were performed. Data were analyzed using the t-test, chi-square test, Pearson correlation coefficients, and multiple logistic regression analyses. The risk factors for IH were predicted after adjusting for BMI, waist circumference (WC), age, hs-CRP and leptin levels, education, and economic status. Results: WC, hs-CRP and leptin levels, and age were higher in the IH group than in the non-IH group. According to the multiple logistic regression analysis, the factors affecting IH prevalence were WC, hs-CRP, leptin, and age. AO (male, WC ≥ 90 cm; female, WC ≥ 85 cm) exhibited an adjusted odds ratio of 5.45 for IH. IH was 2.43 times higher in those with hs-CRP > 3 mg than in those with hs-CRP < 1 mg. As leptin levels increased, the odds ratio for IH increased by 3.05 times. IH was 8.07, 8.79, 18.42, and 35.33 times more common for those in their 30s, 40s, 50s, and ≥ 60 years of age, respectively, than those 19-29 years old. Conclusion: This study provides evidence that interventions for AO should be included in IH management programs. Identifying the predictive factors for IH may contribute to the early detection of type 2 diabetes mellitus.

Keywords

Acknowledgement

This work was supported by 2023 General Research Fund of Journal of Korean Biological Nursing Science, and this work was supported by a National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIT) (No. 2023R1A2C1006271).

References

  1. Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan B, et al. IDF diabetes atlas: global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Research and Clinical Practice. 2022; 183(1):1-13. https://doi.org/10.1016/j.diabres.2021.109119
  2. Vilarino-Garcia T, Polonio-Gonzalez ML, Perez-Perez A, Ribalta J, Arrieta F, Aguilar M. Role of lptin in obesity, cardiovascular disease, and type 2 diabetes. International Journal of Molecular Sciences. 2024;25(4):1-21. https://doi.org/10.3390/ijms25042338 
  3. American Diabetes Association Professional Practice Committee. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes 2022. Diabetes Care. 2022; 45(Suppl.1):S17-S38. https://doi.org/10.2337/dc22-S002
  4. Mainous AG, Rooks BJ, Frank A. Orlando FA. Is there limited utility for lifestyle recommendations for diabetes prevention among overweight or obese depressed patients? Frontiers in Medicine. 2021;8(1):1-5. https://doi.org/10.3389/fmed.2021.757250
  5. Shen J, Kondal D, Rubinstein A, Irazola V, Gutierrez L, Miranda JJ, et al. A multiethnic study of pre-diabetes and diabetes in LMIC. Global Heart. 2016;11(1):61-70. https://doi.org/10.1016/j.gheart.2015.12.015
  6. Modhumi Khan RM, Yu Chua ZY, Tan JC, Yang Y, Liao Z, Zhao Y. From pre-diabetes to diabetes: diagnosis, treatments and translational research. Medicina. 2019;55(9):1-30. https://doi.org/10.3390/medicina55090546
  7. Esser N, Legrand-Poels S, Piette J, Scheen AJ, Paquot N. Inflammation as a link between obesity, metabolic syndrome and type 2 diabetes. Diabetes Research and Clinical Practice. 2014; 105(2):141-150. https://doi.org/10.1016/j.diabres.2014.04.006
  8. Pearson TA, Mensah GA, Alexander RW, Anderson JL, Cannon RO, Criqui M, et al. Markers of inflammation and cardiovascular disease: application to clinical and public health practice: a statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation. 2003;107(3):499-511. https://doi.org/10.1161/01.CIR.0000052939.59093.45
  9. Zhao Y, Li H, Wu X, Li G, Golden AR, Cai L. Rural-urban differentials of prevalence and lifestyle determinants of pre-diabetes and diabetes among the elderly in southwest China. BMC Public Health. 2023;23(1):1-8. https://doi.org/10.1186/s12889-023-15527-9
  10. World Health Organization. Regional Office for the Western?Pacific. Overweight and obesity in the western pacific region: an equity perspective [Internet]. Manila: WHO Regional Office for the Western Pacific; 2017 [cited 2023 Jan 15]. Available from: https://iris.who.int/handle/10665/137517
  11. Ton TT, Tran ATN, Do IT, Nguyen H, Nguyen TTB, Nguyen MT, et al. Trends in prediabetes and diabetes prevalence and associated risk factors in Vietnamese adults. Epidemiol Health. 2020;42(1):1-10. https://doi.org/10.4178/epih.e2020029
  12. Atkins JL, Wannamathee SG. Sarcopenic obesity in ageing: cardiovascular outcomes and mortality. British Journal of Nutrition. 2020;124(10):1102-1113. https://doi.org/10.1017/S0007114520002172
  13. Yun CH, Jhuang JR, Tsou MT. Pericardial fat, thoracic peri-aortic adipose tissue, and systemic inflammatory marker in nonalcoholic fatty liver and abdominal obesity phenotype. Scientific Reports. 2022;12(1958):1-9. https://doi.org/10.1038/s41598-022-06030-z
  14. Neeland IJ, Ross R, Despres JP, Matsuzawa Y, Yamashita S, Shai I, et al. Visceral and ectopic fat, atherosclerosis, and cardiometabolic disease: a position statement. The Lancet Diabetes & Endocrinology. 2019;7(9):715-725. https://doi.org/10.1016/S2213-8587(19)30084-1
  15. Jun JE, Lee SE, Lee YB, Kim G, Jin SM, Lee JH, et al. Low skeletal muscle mass accompanied by abdominal obesity additively increases the risk of incident type 2 diabetes get access arrow. The Journal of Clinical Endocrinology & Metabolism. 2022;17(10):1-10. https://doi.org/10.1210/clinem/dgac662
  16. Bai A, Tao J, Tao L, Liu J. Prevalence and risk factors of diabetes among adults aged 45 years or older in China: a national cross-sectional study. Endocrinology, Diabetes & Metabolism. 2021;4(3):1-10. https://doi.org/10.1002/edm2.265
  17. Nazare JA, Smith JD, Borel AL, Haffner SM, Balkau B, Ross R, et al. Ethnic influences on the relations between abdominal subcutaneous and visceral adiposity, liver fat, and cardiometabolic risk profile: the international study of prediction of intraabdominal adiposity and its relationship with cardiometabolic risk intra-abdominal adiposity. The American Journal of Clinical Nutrition. 2012;96(4):714-726. https://doi. org/10.3945/ajcn.112.035758
  18. Bonamichi BDSF, Lee J. Unusual suspects in the development of obesity-induced inflammation and insulin resistance: NK cells, iNKT cells, and ILCs. Diabetes & Metabolism Journal. 2017; 41(4):229-250. https://doi.org/10.4093/dmj.2017.41.4.229
  19. Phosat C, Panprathip P, Chumpathat N, Prangthip P, Chantratita N, Soonthornworasiri N, et al. Elevated c-reactive protein, interleukin 6, tumor necrosis factor alpha and glycemic load associated with type 2 diabetes mellitus in rural Thais: a cross-sectional study. BMC Endocrine Disorders. 2017; 17(44):1-8. https://doi. org/10.1186/s12902-017-0189-z
  20. Ashraf R, Khan MS, Bhat MH, Shabir I, Rashid S, Majid S. Leptins: association and clinical correlation in pre diabetics. International Journal of Diabetes in Developing Countries. 2022;42(1):683-693. https://doi.org/10.1007/s13410-021-01017-4
  21. Saeed WM, Binjawhar DN. Association of serum leptin and adiponectin concentrations with type 2 diabetes biomarkers and complications among Saudi women. Diabetes, Metabolic Syndrome and Obesity. 2023;16(1):2129-2140. https://doi.org/10.2147/DMSO.S405476
  22. Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behavior Research Methods. 2009;41(1):1149-1160. https://doi. org/10.3758/BRM.41.4.1149
  23. Lee H. Association between obesity and high-sensitivity c-reactive protein in Korean adults without cardiovascular disease. Journal of Korean Biological Nursing Science. 2023; 23(3):32-42. https://doi.org/10.7586/jkbns.23.343
  24. Johari MG, Jokari K, Mirahmadizadeh A, Sief M, Rezaianzadeh A. The prevalence and predictors of pre-diabetes and diabetes among adults 40-70 years in Kharameh cohort study: a population-based study in Fars province, south of Iran. Journal of Diabetes & Metabolic Disorders. 2021;1(1):85-95. https://doi.org/10.1007/s40200-021-00938-5
  25. le Roux CW, Astrup A, Fujioka K, Greenway F, Lau DCW, Van Gaal L, et al. 3 years of liraglutide versus placebo for type 2 diabetes risk reduction and weight management in individuals with prediabetes: a randomised, double-blind trial. The Lancet. 2017;389(1):1399-1409. https://doi.org/10.1016/S0140-6736(17)30069-7
  26. Shin KA. The relationship between metabolic syndrome risk factors and high sensitive c-reactive protein in abdominal obesity elderly women. Korean Journal of Clinical Laboratory Science. 2017;49(2):121-127. https://doi.org/10.15324/kjcls.2017.49.2.121
  27. Cheng ZJ, Wang YF, Jiang XY, Ren WY, Lei SF, Deng FY, et al. High sensitivity c-reactive protein and prediabetes, progression and regression in middle-aged and older adults: a prospective cohort study. Journal of Diabetes Investigation. 2023; 15(1):78-86. https://doi.org/10.1111/jdi.14090
  28. Agarwal T, Lyngdoh T, Dudbridge F, Chandak GR, Kinra S, Prabhakaran D, et al. Causal relationships between lipid and glycemic levels in an Indian population: a bidirectional Mendelian randomization approach. PLoS One. 2020;15(1):1-14. https://doi.org/10.1371/journal.pone.0228269
  29. Hardie DG. AMP-activated protein kinase: a key regulator of energy balance with many roles in human disease. Journal of Internal Medicine. 2014;276(6):543-559. https://doi.org/10.1111/joim.12268
  30. Kang JH, Kim KK. Guidelines for obesity clinic consultations in primary healthcare clinics. Journal of the Korean Medical Association. 2024;67(4):240-255. http://doi.org/10.5124/jkma.2024.67.4.240