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

Abstract

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. 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. 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. 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.