Objectives Adiponectin is closely related to glucose metabolism and traditional diabetes risk factors (obesity, hypertension and dyslipidaemia). We aimed to explore the association between adiponectin levels and newly diagnosed type 2 diabetes mellitus (T2DM) and pre-diabetes in subgroups classified according to T2DM risk factors. Setting Sun Yat-sen Memorial Hospital of Sun Yat-sen University. Participants 3680 individuals (1753 men and 1927 women) aged 18–70 years from Guangzhou and Dongguan, China, were enrolled from December 2018 to October 2019. Primary and secondary outcome measures T2DM was defined as fasting plasma glucose (FPG)≥7.0 mmol/L or HbA1c≥6.5%, and pre-diabetes was defined as 6.1 mmol/L≤FPG<7.0 mmol/L or 5.7≤HbA1c<6.5%. Results With the increasing number of T2DM risk factors, the proportion of the population with high-quartile adiponectin levels gradually decreased (p<0.001). A low level of adiponectin was significantly associated with diabetes and pre-diabetes in a population with ≥1 T2DM risk factor, whereas its association was not consistently significant in the population with all three T2DM risk factors. For instance, participants were more likely to have diabetes or prediabetes with low levels of adiponectin when they had ≥ one T2DM risk factor (quartile 2 vs. 1: OR 0.71 [95%CI: 0.56–0.89]; P=0.003; quartile 3 vs. 1: OR 0.57 [95%CIs: 0.44–0.72]; P<0.001; and quartile 4 vs. 1: OR 0.52 [95%CIs: 0.40–0.67]; P<0.001). Conclusion Adiponectin was negatively associated with diabetes and pre-diabetes in a population with few T2DM risk factors, while their relationship gradually attenuated with the accumulation of T2DM risk factors, especially in a population with coexisting diseases such as obesity, hypertension and dyslipidaemia.

Rational measures in estimating adiposity distribution in diabetic patients has yet to be validated. This study aims to provide insight about the possible links between routinely available body adiposity parameters and the development of both diabetes and insulin resistance. We performed a population-based cross-sectional study in 9496 subjects aged 40 years or older. All of the body adiposity measures including body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), waist-height ratio (WHtR), visceral adiposity index (VAI), body adiposity index (BAI) and lipid accumulation product index (LAP) were separately evaluated according to standard measurement methods. Diabetes was diagnosed according to the American Diabetes Association 2010 criteria. All tested body adiposity measurements were significantly associated with fasting plasma glucose (FPG), oral glucose tolerance test (OGTT) 2 h glucose, HbA1c and fasting insulin. Compared with other adiposity phenotypes, LAP have shown the relatively strongest while BAI have shown the relatively weakest association with increased odds of both diabetes and insulin resistance across all logistic regression models. Additionally, LAP provided the best discrimination accuracy for diabetes [area under the curve (AUC): 0.658 95% confidence intervals (CI) 0.645–0.671] and insulin resistance (AUC: 0.781 95% CI 0.771–0.792) when compared with other body adiposity parameters. The LAP index seems to be a better indicator than other adiposity measures tested in the study to evaluate the association of visceral fat mass with diabetes and insulin resistance, which should be given more consideration in the clinical practice.

Epidemiological evidence suggests that lipid parameters are related to the progression of chronic kidney disease (CKD). Nevertheless, prospective studies that comprehensively assess the effect of routinely available lipid measures on the development of CKD are lacking. The aim of this study was to longitudinally assess the influence of lipid metabolism indicators on the presence of CKD in a large community-based population. We conducted a prospective cohort study at Sun Yat-sen Memorial Hospital, China, with 5345 patients of 40 years or older. Cox regression models were conducted, and hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to assess lipid parameters and their relationship with the incidence of CKD. During the follow-up period, 340 (6.4%) subjects developed CKD. The incidence of CKD increased progressively with quartile values of triglyceride (TG), the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (non-HDL-C/HDL-C) and the ratio of TG to HDL-C, but decreased with HDL-C quartiles (p < 0.0001 for all trends). Pearson’s correlation analysis and multiple regression analyses indicated that these parameters were also associated with various indicators of kidney function. Moreover, we found that among all the lipid parameters, TG/HDL-C emerged as the most effective predictor of CKD. In conclusion, our findings suggest that TG/HDL-C better predicts the incidence of CKD in middle-aged and elderly Chinese individuals than other lipid parameters tested in the study.

Background: In recent years, the impact of visceral fat accumulation on renal damage has garnered significant attention. However, whether visceral fat accumulation contributes to the incidence of both albuminuria and chronic kidney disease (CKD) is still uncertain. Our objective is to look into the possible correlation between visceral adiposity accumulation and incident increased urinary albumin excretion and CKD. Methods: We analyzed data from a cohort of 9916 subjects aged 40 years and above. As an innovative and convenient biomarker of visceral adiposity distribution, visceral adiposity index (VAI) was calculated in accordance with a gender‐specific equation using measurement of blood lipids and anthropometric parameters of obesity. Albuminuria was determined by urine albumin‐to‐creatinine ratio (UACR) ≥ 30 mg/g. CKD was determined by establishment of either of the following: (1) estimated glomerular filtration rate (eGFR) 60 mL/min per 1.73 m ² or less; (2) UACR ≥ 30 mg/g. Results: During an average follow‐up period of 3.6 ± 0.7 years, 245 (4.7%) subjects developed albuminuria and 332 (6.3%) participants developed CKD. Incidence of albuminuria and CKD had a tendency to advance along with ascending VAI levels in both genders. According to multiple stepwise linear regression analysis, γ‐glutamyltransferase (γ‐GGT), fasting insulin, fasting plasma glucose (FPG), low‐density lipoprotein cholesterol (LDL‐C), and systolic blood pressure (SBP) were independent determinants for VAI. Multivariate‐adjusted hazard ratios (HRs) of albuminuria with 95% confidence intervals (CIs) in Cox regression analysis were 1 (reference), 0.82 (0.53–1.29), 1.50 (1.01–2.23), and 1.52 (1.02–2.26) in ascending quartiles of VAI. Similarly, the HRs with 95% CI of CKD in ascending quartiles of VAI were 1 (reference), 0.96 (0.66–1.41), 1.51 (1.07–2.15), and 1.56 (1.10–2.20). For subgroup analyses, VAI significantly correlated with risk of both albuminuria and CKD in older subjects (age ≥ 58 years), nondiabetes subjects, and non‐ASCVD subjects (all p < 0.05). Conclusions: The greater deposition of visceral fat assessed by VAI is independently associated with risk of increased urinary albumin excretion and CKD in middle‐aged and aged Chinese.

This cross-sectional study aimed to investigate the association between non-alcoholic fatty liver disease (NAFLD) and atherosclerotic cardiovascular disease (ASCVD), a global public health concern. A total of 9044 out of 10,104 adults from Guangzhou, China, were included in the analysis. We utilized the fatty liver index (FLI), a noninvasive indicator of NAFLD, and the pooled cohort equations (PCE) based on the 2013 ACC/AHA Guideline, the China-PAR model, and the Framingham Risk Score to assess the 10-year ASCVD risk. The results demonstrated a significant association between FLI and 10-year ASCVD risk (p < 0.001). Adjusted for age, individuals with high FLI (≥60) had an odds ratio of 3.91 (95% CI 2.52–6.08) compared to those with low FLI (<30). These findings persisted after adjusting for metabolic indicators. Notably, this association was consistently observed across all three risk prediction models: the PCE model, the China-PAR model, and the Framingham Risk Score. In conclusion, our study provides evidence supporting FLI as a reliable indicator of increased 10-year ASCVD risk in Chinese NAFLD patients. FLI serves as a valuable marker for early detection of ASCVD, highlighting its potential in clinical practice for risk assessment and prevention strategies.

Background: Individuals with metabolic syndrome have elevated risks of micro- and macro-albuminuria as well as chronic kidney disease (CKD). Objective: To assess the influence of metabolic abnormalities on the presence of low-grade albuminuria (below the threshold for microalbuminuria). Design, participants, and main outcome measures: This community-based cohort study included 3,935 eligible individuals aged 40 years or older. The presence of low-grade albuminuria was detected in those without micro- or macro-albuminuria and analyzed according to the highest quartile of the baseline urinary albumin-to-creatinine ratio (ACR >= 11.13 mg/g). CKD was defined by an estimated glomerular filtration rate = 30 mg/g). Results: Overall, 577 (14.7%) participants developed low-grade albuminuria and 164 (4.2%) participants developed CKD during a mean follow-up period of 3.6 years. Compared with participants without metabolic syndrome, those with metabolic syndrome had greater risks of low-grade albuminuria [adjusted odd ratio (OR) and 95% confidence interval (95% CI): 1.30 (1.05-1.61)] and CKD [1.71 (1.20-2.44)]. Moreover, the incidence rates of low-grade albuminuria and CKD increased as the number of metabolic syndrome components increased (P for trend <0.0001). Conclusions: The presence of metabolic syndrome is associated with increased incidence rates of low-grade albuminuria and CKD the middle-aged and elderly Chinese populations.