Analysis of influencing factors and interaction of body weight and disease outcome in patients with prediabetes

doi:10.4239/wjd.v14.i10.1551

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Oct 15, 2023 (publication date) through Jul 23, 2024

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World Journal of Diabetes

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1948-9358

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

World J Diabetes. Oct 15, 2023; 14(10): 1551-1561
Published online Oct 15, 2023. doi: 10.4239/wjd.v14.i10.1551

Table 1 Weight of prediabetes patients with different blood glucose status

Index	NGT (50 cases)	IFG (98 cases)	IGT (90 cases)	IFG and IGT coexistent (48 cases)
Age (yr)	52.55 ± 14.67	54.68 ± 13.27^a	52.38 ± 11.62^a	57.75 ± 13.68^a
Weight (kg)	61.52 ± 12.13	66.38 ± 13.35^a	70.26 ± 10.62^a	72.26 ± 11.62^a
Waistline (cm)	90.37 ± 9.98	104.25 ± 12.23^a	100.22 ± 8.56^a	107.35 ± 11.07^a
BMI (kg/m2)	25.87 ± 5.46	31.57 ± 4.06^a	30.75 ± 3.39^a	32.27 ± 3.38^a
FBG (mmol/L)	4.46 ± 0.62	6.27 ± 0.75^a	5.58 ± 0.36^a	6.48 ± 0.82^a
2h PG (mmol/L)	5.16 ± 1.08	5.87 ± 0.77^a	8.82 ± 1.17^a	9.35 ± 1.12^a

^aIndicates the same index compared with normal glucose tolerance, P < 0.05.

NGT: Normal glucose tolerance; IFG: Impaired fasting glucose; IGT: Impaired glucose tolerance; BMI: Body mass index; FBG: Fasting blood glucose; 2h PG: 2h postprandial blood glucose.

Table 2 Univariate analysis of the outcome of prediabetes disease

Data	DP group (n = 66)	DO group (n = 170)	t/χ²/Z	P value
Gender			0.143	0.705
Male	39 (59.09)	105 (61.76)
Female	27 (40.91)	65 (38.24)
Age			< 0.001	0.988
< 60 yr	42 (63.64)	108 (63.53)
≥ 60 yr	24 (36.36)	62 (36.47)
Blood glucose status			14.639	0.001
IFG	16 (24.24)	82 (48.24)
IGT	28 (42.42)	62 (36.47)
IFG and IGT coexistent	22 (33.33)	26 (15.29)
Family history of diabetes			0.279	0.598
Yes	6 (9.09)	12 (7.06)
No	60 (90.91)	158 (92.94)
Smoking history			4.561	0.033
Yes	20 (30.30)	30 (17.65)
No	46 (69.70)	140 (82.35)
Drinking history			5.457	0.019
Yes	26 (39.39)	41 (24.12)
No	40 (60.61)	129 (75.88)
Weight, kg (mean ± SD)	74.59 ± 11.19	66.91 ± 11.86	4.535	< 0.001
Waist circumference, cm (mean ± SD)	106.84 ± 10.31	101.98 ± 10.95	3.110	0.002
BMI, kg/m2 (mean ± SD)	32.37 ± 3.58	30.41 ± 3.75	0.074	0.941
FBG, mmol/L (mean ± SD)	5.98 ± 0.73	6.08 ± 0.75	0.926	0.355
2h PG, mmol/L (mean ± SD)	8.12 ± 1.83	7.54 ± 1.84	2.177	0.031
Systolic blood pressure (mmHg)	128 ± 21	122 ± 20	2.040	0.043
Diastolic blood pressure (mmHg)	81 ± 11	80 ± 10	0.670	0.503
Glycosylated hemoglobin (%)	6.28 ± 0.53	5.89 ± 0.33	6.794	< 0.001
TC (mmol/L)	4.76 ± 1.17	4.64 ± 1.06	0.758	0.449
TG (mmol/L)	1.58 ± 0.32	1.42 ± 0.47	2.544	0.012
HDL-C (mmol/L)	1.25 ± 0.27	1.21 ± 0.32	0.899	0.370
LDL-C (mmol/L)	1.88 ± 0.53	1.85 ± 0.41	0.463	0.644
Uric acid (μmol/L)	3.43 ± 0.76	3.20 ± 0.87	2.067	0.040
SLA (μmol/L)	325.10 ± 75.04	300.22 ± 80.23	2.176	0.031
FINS (μU/mL)	5.96 ± 1.57	5.11 ± 1.19	6.016	< 0.001
HOMA-IR	1.67 ± 0.45	1.21 ± 0.39	7.782	< 0.001

Results presented as n (%), unless indicated otherwise. DP: Disease progression; DO: Disease outcome; IFG: Impaired fasting glucose; IGT: Impaired glucose tolerance; BMI: Body mass index; FBG: Fasting blood glucose; 2h PG: 2h postprandial blood glucose; TC: Total cholesterol; TG: Triglycerides; HDL-C: High-density lipoprotein cholesterol; LDL-C: Low-density lipoprotein cholesterol; SLA: Anti-soluble liver antigen antibodies; FINS: Fasting insulin; HOMA-IR: Homeostatic model assessment for insulin resistance.

Table 3 Assignment table

Independent variable	Assignment
Blood glucose status	1 = IFG, 2 = IGT, 3 = IFG and IGT coexist
Smoking history	1 = Yes, 2 = No
Drinking history	1 = Yes, 2 = No
Weight	Measured value
Waist circumference	Measured value
BMI	Measured value
2h PG	Measured value
Systolic blood pressure	Measured value
Glycosylated hemoglobin	Measured value
TG	Measured value
Uric acid	Measured value
SLA	Measured value
FINS	Measured value
HOMA-IR	Measured value

IFG: Impaired fasting glucose; IGT: Impaired glucose tolerance; BMI: Body mass index; 2h PG: 2h postprandial blood glucose; TG: Triglycerides; SLA: Anti-soluble liver antigen antibodies; FINS: Fasting insulin; HOMA-IR: Homeostatic model assessment for insulin resistance.

Table 4 Logistic regression analysis of disease outcomes in prediabetes patients

Independent variable	β	SE	Wals	P value	OR	95%CI
Blood glucose status			1.138	0.566
Blood glucose status (1)	0.034	0.958	0.001	0.972	1.035	0.158-6.771
Blood glucose status (2)	0.588	0.648	0.825	0.364	1.801	0.506-6.415
Smoking history	0.916	0.486	3.553	0.059	2.499	0.964-6.479
Drinking history	0.341	0.457	0.555	0.456	1.406	0.574-3.445
Weight	0.066	0.020	11.128	0.001	1.068	1.028-1.110
Waist circumference	0.041	0.022	3.427	0.064	1.042	0.998-1.089
BMI	0.006	0.060	0.010	0.920	1.006	0.895-1.131
2h PG	0.150	0.204	0.538	0.463	1.162	0.778-1.734
Systolic blood pressure	0.015	0.010	2.213	0.137	1.016	0.995-1.036
Glycosylated hemoglobin	2.542	0.599	18.014	< 0.001	12.705	3.928-41.092
TG	0.527	0.528	0.997	0.318	1.694	0.602-4.772
Uric acid	0.007	0.003	7.217	0.007	1.007	1.002-1.012
SLA	0.001	0.003	0.226	0.635	1.001	0.996-1.007
FINS	0.503	0.169	8.872	0.003	1.653	1.188-2.301
HOMA-IR	2.224	0.547	16.561	< 0.001	9.245	3.167-26.984
Constant (quantity)	-38.654	6.686	33.420	< 0.001	< 0.001	-

BMI: Body mass index; 2h PG: 2h postprandial blood glucose; TG: Triglycerides; SLA: Anti-soluble liver antigen antibodies; FINS: Fasting insulin; HOMA-IR: Homeostatic model assessment for insulin resistance; OR: Odds ratio; CI: Confidence interval.

Table 5 Receiver operating characteristic curve analysis of weight, glycosylated hemoglobin, uric acid, fasting insulin, homeostatic model assessment for insulin resistance in predicting progression of prediabetes to type 2 diabetes mellitus

Independent variable	AUC	95%CI	Specificity	Sensitivity	Optimum break value
Weight	0.699	0.620-0.778	0.729	0.758	71.75
Glycosylated hemoglobin	0.726	0.645-0.806	0.882	0.515	6.25
Uric acid	0.590	0.512-0.668	0.424	0.788	289.5
FINS	0.666	0.583-0.750	0.835	0.500	6.25
HOMA-IR	0.798	0.736-0.859	0.647	0.818	1.35
Collaborative forecasting	0.905	0.863-0.948	-	-

AUC: Area under the curve; FINS: Fasting insulin; HOMA-IR: Homeostatic model assessment for insulin resistance; CI: Confidence interval.

Table 6 Analysis of the influence of weight on disease outcome in patients with prediabetes

Model	Weight 1	Weight 2		Weight 3
Model	Weight 1	OR (95%CI)	P value	OR (95%CI)	P value
Model 1	1	1.210 (1.082-2.532)	0.001	1.366 (1.180-2.743)	0.005
Model 2	1	1.233 (1.085-2.640)	0.005	1.357 (1.166-3.768)	0.008
Model 3	1	1.164 (1.041-1.662)	0.011	1.399 (1.142-2.126)	0.033

No variable adjusted in model 1; model 2 adjusted blood glucose status, smoking history, drinking history, waist circumference and body mass index (BMI); model 3 adjusted blood glucose status, smoking history, drinking history, waist circumference, BMI, 2h postprandial blood glucose, systolic blood pressure, glycosylated hemoglobin, triglycerides, uric acid, anti-soluble liver antigen antibodies, fasting insulin, homeostatic model assessment for insulin resistance; weight 1 is 35-60 kg, weight 2 60-80 kg, and weight 3 is 80-100 kg. OR: Odds ratio; CI: Confidence interval.

Table 7 Analysis of the interaction between body weight and independent influencing factors

Independent variable	β	SE	Wals	P value	OR	95%CI
Weight	2.664	0.52	26.23	< 0.001	14.356	5.179-39.795
Glycosylated hemoglobin	2.772	0.606	20.948	< 0.001	15.987	4.878-52.390
Weight by glycosylated hemoglobin	-0.828	0.82	1.021	0.312	0.437	0.088-2.178
Constant	-3.082	0.457	45.408	< 0.001	0.046	-
Weight	2.453	0.565	18.86	< 0.001	11.625	3.842-35.174
Uric acid	1.887	0.578	10.664	0.001	6.6	2.127-20.484
Weight by uric acid	1.953	0.719	1.758	0.005	0.386	0.094-1.577
Constant	-2.923	0.459	40.545	0	0.054	-
Weight	2.883	0.565	26.066	< 0.001	17.86	5.906-54.009
FINS	2.578	0.622	17.189	< 0.001	13.174	3.894-44.570
Weight by FINS	-0.797	0.833	0.916	0.339	0.451	0.088-2.305
Constant	-3.229	0.51	40.113	< 0.001	0.04	-
Weight	3.31	1.08	9.39	0.002	27.375	3.296-227.343
HOMA-IR	3.067	1.049	8.55	0.003	21.471	2.749-167.718
Weight by HOMA-IR	-1.463	1.15	1.619	0.203	0.231	0.024-2.205
Constant	-4.29	1.007	18.159	< 0.001	0.014	-

FINS: Fasting insulin; HOMA-IR: Homeostatic model assessment for insulin resistance; OR: Odds ratio; CI: Confidence interval.

Citation: Li YY, Tong LP, Wu XD, Lin D, Lin Y, Lin XY. Analysis of influencing factors and interaction of body weight and disease outcome in patients with prediabetes. World J Diabetes 2023; 14(10): 1551-1561
URL: https://www.wjgnet.com/1948-9358/full/v14/i10/1551.htm
DOI: https://dx.doi.org/10.4239/wjd.v14.i10.1551