Effect of Hypertension, Waist-to-Height Ratio, and Their Transitions on the Risk of Type 2 Diabetes Mellitus: Analysis from the China Health and Retirement Longitudinal Study

Background. Diabetes is a major reason of death and disability worldwide and frequently coexists with hypertension and central obesity. This study is aimed at investigating the effects of hypertension, waist-to-height ratio (WHtR), and their dynamic transitions on type 2 diabetes mellitus (T2DM) ons...

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Main Authors: Lin Han, Xiaoyan Li, Xin Wang, Jiao Zhou, Qiang Wang, Xiujuan Rong, Gang Wang, Xiaoli Shao
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Journal of Diabetes Research
Online Access:http://dx.doi.org/10.1155/2022/7311950
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author Lin Han
Xiaoyan Li
Xin Wang
Jiao Zhou
Qiang Wang
Xiujuan Rong
Gang Wang
Xiaoli Shao
author_facet Lin Han
Xiaoyan Li
Xin Wang
Jiao Zhou
Qiang Wang
Xiujuan Rong
Gang Wang
Xiaoli Shao
author_sort Lin Han
collection DOAJ
description Background. Diabetes is a major reason of death and disability worldwide and frequently coexists with hypertension and central obesity. This study is aimed at investigating the effects of hypertension, waist-to-height ratio (WHtR), and their dynamic transitions on type 2 diabetes mellitus (T2DM) onset among middle-aged and elderly people in China. Methods. We analyzed 9843 participants free of T2DM (average age, 59.04±9.26 years) at baseline from the China Health and Retirement Longitudinal Study. We classified the participants into the following four categories based on hypertension and WHtR statuses: nonhypertensive with a normal WHtR (NHNW); hypertensive with a normal WHtR (HTNW); nonhypertensive with an elevated WHtR (NHEW); and hypertensive with an elevated WHtR (HTEW). By using a Cox proportional hazards regression model, we assessed whether hypertension, WHtR, and their transitions over time correlated with T2DM risk. Results. During the follow-up of 8 years, 1263 participants developed incident T2DM. The hazard ratio (HR) for T2DM was 1.48 (95% CI: 1.12, 1.97), 1.56 (95% CI: 1.27, 1.92), and 2.15 (95% CI: 1.74, 2.67) in the HTNW, NHEW, and HTEW groups, respectively, compared with the NHNW group after controlling for confounding factors. When stratified by statuses of hypertension and WHtR transitions, the participants who transitioned from HTNW to HTEW (HR=1.98, 95% CI: 1.24-3.17), or NHEW to NHNW/HTNW (HR=1.74, 95% CI: 1.14–2.65), or remained NHEW (HR=1.42, 95% CI: 1.04-1.93), or NHEW to HTEW (HR=2.40, 95% CI: 1.66-3.49), or remained HTEW (HR=2.51, 95% CI: 1.87-3.37) during the follow-up period showed a higher T2DM risk than the consistently NHNW participants. Conclusions. Being HTNW, NHEW or HTEW or occurring adverse transitions between those states was strongly associated with T2DM onset. Effectively warding off hypertension and central obesity or preventing their further aggravation may substantially decrease the T2DM risk.
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spelling doaj-art-4299277ddeca49da8a7148eccd5cd3092025-08-20T02:39:15ZengWileyJournal of Diabetes Research2314-67532022-01-01202210.1155/2022/7311950Effect of Hypertension, Waist-to-Height Ratio, and Their Transitions on the Risk of Type 2 Diabetes Mellitus: Analysis from the China Health and Retirement Longitudinal StudyLin Han0Xiaoyan Li1Xin Wang2Jiao Zhou3Qiang Wang4Xiujuan Rong5Gang Wang6Xiaoli Shao7The First Affiliated Hospital of Xi’an Medical UniversityThe First Affiliated Hospital of Xi’an Medical UniversityThe First Affiliated Hospital of Xi’an Medical UniversityThe First Affiliated Hospital of Xi’an Medical UniversityThe First Affiliated Hospital of Xi’an Medical UniversityHeze Medical UniversityThe First Affiliated Hospital of Xi’an Medical UniversityThe First Affiliated Hospital of Xi’an Medical UniversityBackground. Diabetes is a major reason of death and disability worldwide and frequently coexists with hypertension and central obesity. This study is aimed at investigating the effects of hypertension, waist-to-height ratio (WHtR), and their dynamic transitions on type 2 diabetes mellitus (T2DM) onset among middle-aged and elderly people in China. Methods. We analyzed 9843 participants free of T2DM (average age, 59.04±9.26 years) at baseline from the China Health and Retirement Longitudinal Study. We classified the participants into the following four categories based on hypertension and WHtR statuses: nonhypertensive with a normal WHtR (NHNW); hypertensive with a normal WHtR (HTNW); nonhypertensive with an elevated WHtR (NHEW); and hypertensive with an elevated WHtR (HTEW). By using a Cox proportional hazards regression model, we assessed whether hypertension, WHtR, and their transitions over time correlated with T2DM risk. Results. During the follow-up of 8 years, 1263 participants developed incident T2DM. The hazard ratio (HR) for T2DM was 1.48 (95% CI: 1.12, 1.97), 1.56 (95% CI: 1.27, 1.92), and 2.15 (95% CI: 1.74, 2.67) in the HTNW, NHEW, and HTEW groups, respectively, compared with the NHNW group after controlling for confounding factors. When stratified by statuses of hypertension and WHtR transitions, the participants who transitioned from HTNW to HTEW (HR=1.98, 95% CI: 1.24-3.17), or NHEW to NHNW/HTNW (HR=1.74, 95% CI: 1.14–2.65), or remained NHEW (HR=1.42, 95% CI: 1.04-1.93), or NHEW to HTEW (HR=2.40, 95% CI: 1.66-3.49), or remained HTEW (HR=2.51, 95% CI: 1.87-3.37) during the follow-up period showed a higher T2DM risk than the consistently NHNW participants. Conclusions. Being HTNW, NHEW or HTEW or occurring adverse transitions between those states was strongly associated with T2DM onset. Effectively warding off hypertension and central obesity or preventing their further aggravation may substantially decrease the T2DM risk.http://dx.doi.org/10.1155/2022/7311950
spellingShingle Lin Han
Xiaoyan Li
Xin Wang
Jiao Zhou
Qiang Wang
Xiujuan Rong
Gang Wang
Xiaoli Shao
Effect of Hypertension, Waist-to-Height Ratio, and Their Transitions on the Risk of Type 2 Diabetes Mellitus: Analysis from the China Health and Retirement Longitudinal Study
Journal of Diabetes Research
title Effect of Hypertension, Waist-to-Height Ratio, and Their Transitions on the Risk of Type 2 Diabetes Mellitus: Analysis from the China Health and Retirement Longitudinal Study
title_full Effect of Hypertension, Waist-to-Height Ratio, and Their Transitions on the Risk of Type 2 Diabetes Mellitus: Analysis from the China Health and Retirement Longitudinal Study
title_fullStr Effect of Hypertension, Waist-to-Height Ratio, and Their Transitions on the Risk of Type 2 Diabetes Mellitus: Analysis from the China Health and Retirement Longitudinal Study
title_full_unstemmed Effect of Hypertension, Waist-to-Height Ratio, and Their Transitions on the Risk of Type 2 Diabetes Mellitus: Analysis from the China Health and Retirement Longitudinal Study
title_short Effect of Hypertension, Waist-to-Height Ratio, and Their Transitions on the Risk of Type 2 Diabetes Mellitus: Analysis from the China Health and Retirement Longitudinal Study
title_sort effect of hypertension waist to height ratio and their transitions on the risk of type 2 diabetes mellitus analysis from the china health and retirement longitudinal study
url http://dx.doi.org/10.1155/2022/7311950
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