The modified role including mediating and synergistic interactive effects of glucose tolerance status in the associations between relative fat mass and the risks of cardiovascular disease and all-cause mortality from the 4C cohort study
Abstract Background To investigate the associations between relative fat mass (RFM) and clinical outcomes in different glucose tolerance statuses and the modified effect of glucose tolerance status. Methods We analyzed 8,224 participants from a Chinese cohort study, who were classified into normal g...
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BMC
2024-12-01
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| Series: | Diabetology & Metabolic Syndrome |
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| Online Access: | https://doi.org/10.1186/s13098-024-01558-8 |
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| author | Peiqiong Luo Danpei Li Yaming Guo Xiaoyu Meng Ranran Kan Xuefeng Yu |
| author_facet | Peiqiong Luo Danpei Li Yaming Guo Xiaoyu Meng Ranran Kan Xuefeng Yu |
| author_sort | Peiqiong Luo |
| collection | DOAJ |
| description | Abstract Background To investigate the associations between relative fat mass (RFM) and clinical outcomes in different glucose tolerance statuses and the modified effect of glucose tolerance status. Methods We analyzed 8,224 participants from a Chinese cohort study, who were classified into normal glucose status (NGT), prediabetes, and diabetes. Outcomes included fatal, nonfatal cardiovascular disease (CVD) events and all-cause mortality. Associations between RFM and outcomes were assessed using Cox regression. The modified effect of glucose tolerance status was investigated using mediation, interaction, and joint analyses. Results During up to 5 years of follow-up, 154 (1.9%) participants experienced fatal CVD, 153 (1.9%) experienced nonfatal CVD events, and 294 (3.6%) experienced all-cause death. 2,679 participants (32.6%) had NGT, 4,528 (54.8%) had prediabetes, and 1,037 (12.6%) had diabetes. RFM was associated with increased risk of fatal (HR [95% CI], 1.09 [1.06–1.12], p < 0.001), nonfatal CVD events (HR [95% CI], 1.12 [1.09–1.15], p < 0.001), and all-cause mortality (HR [95% CI], 1.10 [1.08–1.12), p < 0.001) in all and those with NGT, prediabetes, and diabetes, and these associations were modified by glucose tolerance status, which included mediating (mediation proportion ranges from 4.74% to 8.69%) and synergistic interactive effects (multiplicative effect ranges from 1.03 to 1.06). The joint analysis identified the subclassification that exhibited the highest HR among 12 subclassifications. Conclusions RFM was associated with increased risk of fatal, nonfatal CVD events, and all-cause mortality in NGT, prediabetes, and diabetes, and these associations were modified by glucose tolerance status, which could significantly influence how clinicians assess high risk and could lead to more personalized, effective prevention strategies. |
| format | Article |
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| institution | Kabale University |
| issn | 1758-5996 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
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| series | Diabetology & Metabolic Syndrome |
| spelling | doaj-art-7c0c31046f8c4840a32b3b69de3deea32024-12-29T12:39:20ZengBMCDiabetology & Metabolic Syndrome1758-59962024-12-0116111810.1186/s13098-024-01558-8The modified role including mediating and synergistic interactive effects of glucose tolerance status in the associations between relative fat mass and the risks of cardiovascular disease and all-cause mortality from the 4C cohort studyPeiqiong Luo0Danpei Li1Yaming Guo2Xiaoyu Meng3Ranran Kan4Xuefeng Yu5Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDivision of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDivision of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDivision of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDivision of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDivision of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyAbstract Background To investigate the associations between relative fat mass (RFM) and clinical outcomes in different glucose tolerance statuses and the modified effect of glucose tolerance status. Methods We analyzed 8,224 participants from a Chinese cohort study, who were classified into normal glucose status (NGT), prediabetes, and diabetes. Outcomes included fatal, nonfatal cardiovascular disease (CVD) events and all-cause mortality. Associations between RFM and outcomes were assessed using Cox regression. The modified effect of glucose tolerance status was investigated using mediation, interaction, and joint analyses. Results During up to 5 years of follow-up, 154 (1.9%) participants experienced fatal CVD, 153 (1.9%) experienced nonfatal CVD events, and 294 (3.6%) experienced all-cause death. 2,679 participants (32.6%) had NGT, 4,528 (54.8%) had prediabetes, and 1,037 (12.6%) had diabetes. RFM was associated with increased risk of fatal (HR [95% CI], 1.09 [1.06–1.12], p < 0.001), nonfatal CVD events (HR [95% CI], 1.12 [1.09–1.15], p < 0.001), and all-cause mortality (HR [95% CI], 1.10 [1.08–1.12), p < 0.001) in all and those with NGT, prediabetes, and diabetes, and these associations were modified by glucose tolerance status, which included mediating (mediation proportion ranges from 4.74% to 8.69%) and synergistic interactive effects (multiplicative effect ranges from 1.03 to 1.06). The joint analysis identified the subclassification that exhibited the highest HR among 12 subclassifications. Conclusions RFM was associated with increased risk of fatal, nonfatal CVD events, and all-cause mortality in NGT, prediabetes, and diabetes, and these associations were modified by glucose tolerance status, which could significantly influence how clinicians assess high risk and could lead to more personalized, effective prevention strategies.https://doi.org/10.1186/s13098-024-01558-8Cardiovascular diseaseAll-cause mortalityGlucose tolerance statusesRelative fat massMediation analysisInteraction analysis |
| spellingShingle | Peiqiong Luo Danpei Li Yaming Guo Xiaoyu Meng Ranran Kan Xuefeng Yu The modified role including mediating and synergistic interactive effects of glucose tolerance status in the associations between relative fat mass and the risks of cardiovascular disease and all-cause mortality from the 4C cohort study Diabetology & Metabolic Syndrome Cardiovascular disease All-cause mortality Glucose tolerance statuses Relative fat mass Mediation analysis Interaction analysis |
| title | The modified role including mediating and synergistic interactive effects of glucose tolerance status in the associations between relative fat mass and the risks of cardiovascular disease and all-cause mortality from the 4C cohort study |
| title_full | The modified role including mediating and synergistic interactive effects of glucose tolerance status in the associations between relative fat mass and the risks of cardiovascular disease and all-cause mortality from the 4C cohort study |
| title_fullStr | The modified role including mediating and synergistic interactive effects of glucose tolerance status in the associations between relative fat mass and the risks of cardiovascular disease and all-cause mortality from the 4C cohort study |
| title_full_unstemmed | The modified role including mediating and synergistic interactive effects of glucose tolerance status in the associations between relative fat mass and the risks of cardiovascular disease and all-cause mortality from the 4C cohort study |
| title_short | The modified role including mediating and synergistic interactive effects of glucose tolerance status in the associations between relative fat mass and the risks of cardiovascular disease and all-cause mortality from the 4C cohort study |
| title_sort | modified role including mediating and synergistic interactive effects of glucose tolerance status in the associations between relative fat mass and the risks of cardiovascular disease and all cause mortality from the 4c cohort study |
| topic | Cardiovascular disease All-cause mortality Glucose tolerance statuses Relative fat mass Mediation analysis Interaction analysis |
| url | https://doi.org/10.1186/s13098-024-01558-8 |
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