Background: Body roundness index (BRI) is one of the obesity-related anthropometric indices. However, studies on the relationship between BRI and diabetes risk is limited. The purpose of this study was to explore the relationship between baseline BRI and incident type 2 diabetes mellitus (T2DM) in the Japanese population. Methods: A retrospective longitudinal study of 15,310 participants in a physical examination program at Murakami Memorial Hospital in Japan from 2004 to 2015. The association between BRI levels and incident T2DM was analyzed by Cox proportional-hazards regression, smooth curve fitting, subgroup analyses, and a set of sensitivity analyses. Receiver operating characteristic curve analysis was used to assess the ability of BRI to predict diabetes. Result: Baseline BRI levels were elevated in participants who developed T2DM. Baseline BRI levels were positively associated with incident T2DM after adjusting confounding variables (HR = 1.570, 95% CI 1.360–1.811). Additionally, we did a set of sensitivity analyses to ensure the robustness of the results. There was also a non-linear relationship between BRI and incident diabetes in both genders, and the inflection point of BRI was 4.137 in females and 3.146 in males. We found a strong positive correlation between BRI and the incidence of diabetes on the right of the inflection point (Male: HR = 1.827, 95% CI 1.449–2.303; Female: HR = 4.189, 95% CI 1.862–9.421). What’s more, among the anthropometric indices, BRI showed the optimal capability to predict T2DM (Male: AUC = 0.706, 95% CI 0.674–0.738; Female: AUC = 0.735, 95% CI 0.676–0.795). Conclusion: An elevated BRI level in baseline was independently associated with incident T2DM. Baseline BRI improves the identification of patients at risk of T2DM and may enable early and optimized therapy to improve their outcomes.

Background: Evidence about the relationship between triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio and prediabetes (Pre-DM) in Chinese non-obese people with a normal range of low-density lipoprotein cholesterol (LDL-c) is limited. Therefore, the present study was undertaken to explore the link of the TG/HDL-C ratio on Pre-DM among non-obese Chinese population with a normal range of LDL-c. Methods: This study was a cross-sectional study that enrolled 153163 non-obese individuals with a normal range of low-density lipoprotein cholesterol in a Chinese hospital from January 2010 to December 2014. Logistic regression model, generalized additive model (GAM), smooth curve fitting and a series of sensitivity analyses was used to evaluate the association between TG/HDL-C ratio and Pre-DM. Result: The prevalence of Pre-DM was 9.77%.The median TG/HDL-C ratio was 0.671 (interquartile range, 0.468–1.010). After adjusting covariates, the results showed that TG/HDL-C ratio was positively associated with Pre-DM ((OR = 1.185, 95%CI 1.145–1.226). In addition, the TG/HDL-C ratio level has a non-linear relationship with the incidence of Pre-DM, in which the inflection point was 1.617. The effect sizes (OR) on the left and right sides of the inflection point were 1.312 (95%CI 1.242–1.386) and 0.980 (95%CI 0.898–1.070), respectively. And the sensitive analysis demonstrated the robustness of the results. Subgroup analysis showed a stronger association between TG/HDL-C ratio and Pre-DM in females and the population with 30 years < age < 40 years, 18.5 kg/m² < body mass index < 24 kg/m², and ALT < 40U/L. Conclusion: This study demonstrates a positive and non-linear relationship between TG/HDL-C ratio and Pre-DM in Chinese non-obese people with a normal range of low-density lipoprotein cholesterol. TG/HDL-C ratio is strongly related to Pre-DM when TG/HDL-C ratio is less than 1.617. It makes sense to reduce the TG/HDL-C ratio level below the inflection point from a treatment perspective.

Objective: Albumin-corrected calcium is usually calculated to reflect the real serum calcium level of the whole body by physicians. However, studies on the association between albumin-corrected calcium and 30-day in-hospital mortality in Intensive Care Unit (ICU) patients are rare. The purpose of our study was to explore the association between baseline albumin-corrected calcium and 30-day in-hospital mortality in the American ICU population.Methods: A multicenter retrospective cohort study of 102,245 ICU patients in the eICU-CRD v2.0 from the USA during 2014–2015 was performed. The average age was 63.7 ± 16.9 years, of which 55,313 (53.7%) were men and 47,758 (46.3%) were women. The association between albumin-corrected calcium and 30-day in-hospital mortality was analyzed by Cox proportional-hazards regression, smooth curve fitting, piecewise linear regression, subgroup analyses, and a series of sensitivity analyses.Results: We found that among ICU patients with calcium abnormalities, more than 95% were mild hypocalcemia or mild hypercalcemia. The risk of 30-day in-hospital mortality will increase by 10% in the ≥7.5–< 8.5 mg/dl subgroup (OR=1.1, 95% CI 1.0–1.3) or 20% in the ≥10.3–<12 mg/dl subgroup (OR=1.2, 95% CI 1.1–1.3) when the albumin-corrected calcium level increases by 1 mg/dl. Additionally, the relationship between albumin-corrected calcium and 30-day in-hospital mortality was U shaped; the inflection point was 8.9 mg/dl (log likelihood ratio test P = 0.005). Finally, after a series of sensitivity analyses, we found that the relationship between albumin-corrected calcium and 30-day in-hospital mortality remained significant.Conclusion: In a large nationally representative cohort of ICU patients, abnormalities in albumin-corrected calcium, particularly slight hypocalcemia or slight hypercalcemia, were associated with an increased 30-day in-hospital mortality risk, and yet the findings in this study need to be further confirmed by prospective studies.