The importance of waist circumference and BMI for mortality risk in diabetic adults

Peter T Katzmarzyk, Gang Hu, William T Cefalu, Emily Mire, Claude Bouchard, Peter T Katzmarzyk, Gang Hu, William T Cefalu, Emily Mire, Claude Bouchard

Abstract

Objective: We aimed to determine the associations of waist circumference (WC) and BMI with all-cause mortality among patients with diabetes.

Research design and methods: The sample included 847 white and 553 African American patients (18-69 years of age) with diabetes. Height, weight, and WC were measured, and the BMI (kg/m2) was calculated. Cox regression was used to analyze the associations of BMI and WC with mortality, adjusting for age, sex, race, examination year, smoking status, alcohol consumption, and physical activity. Hazard ratios (HRs) are expressed per standard deviation of each independent variable.

Results: A total of 86 deaths occurred during 6.7 years of follow-up. After adjustment for covariates, WC (HR 1.40 [95% CI 1.14-1.72]) and BMI (1.29 [1.04-1.61]) demonstrated significant relationships with mortality.

Conclusions: The results indicate that maintaining a healthy WC and BMI are both important for individuals living with diabetes.

Figures

Figure 1
Figure 1
HRs for all-cause mortality across tertiles of BMI (A) and WC (B) are shown among patients with diabetes in the Pennington Center Longitudinal Study. Error bars represent the 95% CI. Cutoffs for the tertiles were 32 and 38 kg/m2 for BMI and 104 and 116 cm for WC. HRs are adjusted for age, year of examination, sex, race, smoking, alcohol consumption, and physical activity.

References

    1. Centers for Disease Control and Prevention (CDC) Increasing prevalence of diagnosed diabetes—United States and Puerto Rico, 1995-2010. MMWR Morb Mortal Wkly Rep 2012;61:918–921
    1. American Diabetes Association Standards of medical care in diabetes—2013. Diabetes Care 2013;36(Suppl. 1):S11–S66
    1. Kodama S, Horikawa C, Fujihara K, et al. Comparisons of the strength of associations with future type 2 diabetes risk among anthropometric obesity indicators, including waist-to-height ratio: a meta-analysis. Am J Epidemiol 2012;176:959–969
    1. Vazquez G, Duval S, Jacobs DR, Jr, Silventoinen K. Comparison of body mass index, waist circumference, and waist/hip ratio in predicting incident diabetes: a meta-analysis. Epidemiol Rev 2007;29:115–128
    1. Hu G, Jousilahti P, Barengo NC, Qiao Q, Lakka TA, Tuomilehto J. Physical activity, cardiovascular risk factors, and mortality among Finnish adults with diabetes. Diabetes Care 2005;28:799–805
    1. Carnethon MR, De Chavez PJ, Biggs ML, et al. Association of weight status with mortality in adults with incident diabetes. JAMA 2012;308:581–590
    1. Doehner W, Erdmann E, Cairns R, et al. Inverse relation of body weight and weight change with mortality and morbidity in patients with type 2 diabetes and cardiovascular co-morbidity: an analysis of the PROactive study population. Int J Cardiol 2012;162:20–26
    1. Kokkinos P, Myers J, Faselis C, Doumas M, Kheirbek R, Nylen E. BMI-mortality paradox and fitness in African American and Caucasian men with type 2 diabetes. Diabetes Care 2012;35:1021–1027
    1. McEwen LN, Kim C, Karter AJ, et al. Risk factors for mortality among patients with diabetes: the Translating Research Into Action for Diabetes (TRIAD) Study. Diabetes Care 2007;30:1736–1741
    1. Khalangot M, Tronko M, Kravchenko V, Kulchinska J, Hu G. Body mass index and the risk of total and cardiovascular mortality among patients with type 2 diabetes: a large prospective study in Ukraine. Heart 2009;95:454–460
    1. So WY, Yang X, Ma RC, et al. Risk factors in V-shaped risk associations with all-cause mortality in type 2 diabetes-The Hong Kong Diabetes Registry. Diabetes Metab Res Rev 2008;24:238–246
    1. McEwen LN, Karter AJ, Waitzfelder BE, et al. Predictors of mortality over 8 years in type 2 diabetic patients: Translating Research Into Action for Diabetes (TRIAD). Diabetes Care 2012;35:1301–1309
    1. Heymsfield SB, Cefalu WT. Does body mass index adequately convey a patient’s mortality risk? JAMA 2013;309:87–88
    1. Katzmarzyk PT, Bray GA, Greenway FL, et al. Racial differences in abdominal depot-specific adiposity in white and African American adults. Am J Clin Nutr 2010;91:7–15
    1. Katzmarzyk PT, Mire E, Bray GA, Greenway FL, Heymsfield SB, Bouchard C. Anthropometric markers of obesity and all-cause mortality in white and African American adults: The Pennington Center Longitudinal Study. Obesity (Silver Spring) (in press)
    1. MacMahon B. The National Death Index. Am J Public Health 1983;73:1247–1248

Source: PubMed

Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

3
Abonner