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已发表论文
2 型糖尿病中老年患者中不同人体测量指标与左心室肥厚的性别特异性关联
Authors Liu G, Tian Q, Cui Q, Zhang R , Wang C, Fang D, Sun Z , Zou D, Chen X, Zheng R, Yuan X
Received 11 September 2025
Accepted for publication 30 November 2025
Published 15 December 2025 Volume 2025:18 Pages 4559—4570
DOI https://doi.org/10.2147/DMSO.S566225
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Donald McClain
Guilin Liu,1,* Qingxiu Tian,1,2,* Qian Cui,3 Rong Zhang,1 Chunru Wang,4 Dan Fang,5 Zhenzhen Sun,6 Daoyuan Zou,7,8 Xiaodong Chen,9 Rendong Zheng,10 Xiaodan Yuan11
1School of Nursing, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China; 2Department of Nutrition, Xuyi County T.C.M. Hospital, Huai’an, People’s Republic of China; 3Department of Endocrinology, Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University, Changzhou, People’s Republic of China; 4Statistics Office, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China; 5Nursing College, Suzhou Vocational Health College, Suzhou, People’s Republic of China; 6Department of Endocrinology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China; 7Department of Ultrasound, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China; 8Department of Ultrasound, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, People’s Republic of China; 9Department of Cardiology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China; 10Department of Endocrinology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China; 11Department of Public Health, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Xiaodan Yuan, Email yuanxiaodan107@163.com Rendong Zheng, Email zhrd2000@sina.com
Objective: To investigate the associations of anthropometric indicators and left ventricular hypertrophy (LVH) in middle-aged and elderly individuals with type 2 diabetes mellitus (T2DM).
Methods: This was a cross-sectional study. A total of 3330 individuals were recruited from three tertiary hospitals across China between July 2018 and June 2023. Demographic characteristics, biochemical parameters, and echocardiographic measurements were systematically collected. Anthropometric indices, including body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), body adiposity index (BAI), body roundness index (BRI), and weight-adjusted-waist index (WWI) were calculated using standardized protocols. Multivariable binary logistic regression models were employed to evaluate the associations between anthropometric indices and LVH. The diagnostic accuracy was assessed using receiver operating characteristic (ROC) curve analysis.
Results: Multivariable logistic regression analysis revealed that WHR (OR:1.128, 95% CI:1.043, 1.220) and BRI (OR:1.455, 95% CI:1.011, 2.094) were independently associated with increased LVH risk in middle-aged males. Among middle-aged females, BAI (OR:1.112, 95% CI:1.046, 1.182), WHtR (OR:1.048, 95% CI:1.007, 1.090), and BRI (OR:1.234, 95% CI:1.040, 1.465) demonstrated significant associations with LVH. However, in the elderly population, none of the variables showed a statistically significant association with LVH (P> 0.05). ROC curve analysis identified WHR as the strongest predictor in middle-aged males (AUC:0.674, 95% CI:0.584, 0.764), whereas BAI exhibited the highest discriminatory accuracy among middle-aged females (AUC:0.578, 95% CI:0.523, 0.633).
Conclusion: Sex-specific associations between obesity indices and LVH were observed in middle-aged individuals with T2DM, necessitating distinct risk-stratification strategies: prioritizing abdominal obesity in males and comprehensive adiposity distribution in females. Notably, the broad relevance of BRI in both sexes highlights its clinical utility.
Keywords: type 2 diabetes mellitus, anthropometric indices, left ventricular hypertrophy, sex differences
1School of Nursing, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China; 2Department of Nutrition, Xuyi County T.C.M. Hospital, Huai’an, People’s Republic of China; 3Department of Endocrinology, Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University, Changzhou, People’s Republic of China; 4Statistics Office, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China; 5Nursing College, Suzhou Vocational Health College, Suzhou, People’s Republic of China; 6Department of Endocrinology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China; 7Department of Ultrasound, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China; 8Department of Ultrasound, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, People’s Republic of China; 9Department of Cardiology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China; 10Department of Endocrinology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China; 11Department of Public Health, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Xiaodan Yuan, Email yuanxiaodan107@163.com Rendong Zheng, Email zhrd2000@sina.com
Objective: To investigate the associations of anthropometric indicators and left ventricular hypertrophy (LVH) in middle-aged and elderly individuals with type 2 diabetes mellitus (T2DM).
Methods: This was a cross-sectional study. A total of 3330 individuals were recruited from three tertiary hospitals across China between July 2018 and June 2023. Demographic characteristics, biochemical parameters, and echocardiographic measurements were systematically collected. Anthropometric indices, including body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), body adiposity index (BAI), body roundness index (BRI), and weight-adjusted-waist index (WWI) were calculated using standardized protocols. Multivariable binary logistic regression models were employed to evaluate the associations between anthropometric indices and LVH. The diagnostic accuracy was assessed using receiver operating characteristic (ROC) curve analysis.
Results: Multivariable logistic regression analysis revealed that WHR (OR:1.128, 95% CI:1.043, 1.220) and BRI (OR:1.455, 95% CI:1.011, 2.094) were independently associated with increased LVH risk in middle-aged males. Among middle-aged females, BAI (OR:1.112, 95% CI:1.046, 1.182), WHtR (OR:1.048, 95% CI:1.007, 1.090), and BRI (OR:1.234, 95% CI:1.040, 1.465) demonstrated significant associations with LVH. However, in the elderly population, none of the variables showed a statistically significant association with LVH (P> 0.05). ROC curve analysis identified WHR as the strongest predictor in middle-aged males (AUC:0.674, 95% CI:0.584, 0.764), whereas BAI exhibited the highest discriminatory accuracy among middle-aged females (AUC:0.578, 95% CI:0.523, 0.633).
Conclusion: Sex-specific associations between obesity indices and LVH were observed in middle-aged individuals with T2DM, necessitating distinct risk-stratification strategies: prioritizing abdominal obesity in males and comprehensive adiposity distribution in females. Notably, the broad relevance of BRI in both sexes highlights its clinical utility.
Keywords: type 2 diabetes mellitus, anthropometric indices, left ventricular hypertrophy, sex differences