Prevalence of hypertriglyceridemic-waist phenotype and its association with type 2 diabetes mellitus among middle-aged and older adults of Amerindian ancestry.

IF 2.5 Q1 PRIMARY HEALTH CARE

Journal of Primary Care and Community Health Pub Date : 2025-01-01 Epub Date: 2025-07-31 DOI:10.1177/21501319251362044

Denisse A Rumbea, Robertino M Mera, Emilio E Arias, Kleber Arriaga, Oscar H Del Brutto

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Abstract

Background: The hypertriglyceridemic-waist phenotype (HTWP), defined by concurrent hypertriglyceridemia and increased waist circumference, is a recognized marker of metabolic and cardiovascular risk. While extensively studied across populations, data on Amerindian communities remain scarce. This study examines HTWP prevalence and its association with type 2 diabetes mellitus in middle-aged and older adults of Amerindian ancestry in rural Ecuador.

Methods: This population-based cross-sectional study was conducted in 3 ethnically homogeneous villages. Participants aged ≥40 years underwent standardized assessments, including structured interviews and fasting blood tests. HTWP was defined using serum triglyceride levels ≥150 mg/dL together with increased waist circumference determined by 2 criteria: Amerindian-specific (men ≥ 89 cm, women ≥83 cm) and NCEP-ATP III (men ≥102 cm, women ≥88 cm). Logistic regression models assessed associations between HTWP and diabetes indicators, adjusting for demographics and cardiovascular risk factors.

Results: Among 1354 participants, HTWP prevalence was 47% by Amerindian-specific, and 30% using NCEP-ATP III criteria. Hypertriglyceridemia was frequent (55%), particularly in men. In multivariate models, HTWP was associated with fasting glucose ≥126 mg/dL under both Amerindian-specific (OR 1.32, 95% CI 1.02-1.71) and NCEP-ATP III (OR 1.50, 95% CI 1.12-2.01) criteria. When HTWP components were separately included in the models, only hypertriglyceridemia remained significantly associated with diabetes risk. No significant association was observed between HTWP and HbA1c levels.

Conclusion: HTWP prevalence is high in this population. Hypertriglyceridemia drives diabetes risk more than waist circumference. Findings underscore the need for ethnicity-specific cardiovascular risk assessments and targeted health interventions for indigenous communities.

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美洲印第安人中老年人群中高甘油三酯-腰围表型患病率及其与2型糖尿病的关系

背景：高甘油三酯-腰围表型（HTWP），由同时出现的高甘油三酯血症和腰围增加所定义，是公认的代谢和心血管风险的标志。虽然对人口进行了广泛的研究，但关于美洲印第安人社区的数据仍然很少。本研究调查了厄瓜多尔农村美洲印第安人中老年人群中HTWP患病率及其与2型糖尿病的关系。方法：以人口为基础的横断面研究在3个民族同质村进行。年龄≥40岁的参与者接受标准化评估，包括结构化访谈和空腹血液检查。HTWP的定义是血清甘油三酯水平≥150mg /dL，腰围增加由2个标准确定：美洲印第安人特异性（男性≥89 cm，女性≥83 cm）和NCEP-ATP III（男性≥102 cm，女性≥88 cm）。Logistic回归模型评估了HTWP与糖尿病指标之间的关联，调整了人口统计学和心血管危险因素。结果：在1354名参与者中，HTWP患病率为47%，美国印第安人特异性，30%使用NCEP-ATP III标准。高甘油三酯血症很常见（55%），尤其是男性。在多变量模型中，在印第安人特异性（OR 1.32, 95% CI 1.02-1.71）和NCEP-ATP III （OR 1.50, 95% CI 1.12-2.01）标准下，HTWP与空腹血糖≥126 mg/dL相关。当HTWP成分单独包括在模型中时，只有高甘油三酯血症仍然与糖尿病风险显著相关。HTWP与HbA1c水平无显著相关性。结论：该人群HTWP患病率较高。高甘油三酯血症比腰围更容易引发糖尿病。研究结果强调需要针对特定种族的心血管风险评估和针对土著社区的有针对性的健康干预措施。

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