Neck circumference and waist circumference associated with cardiovascular events in type 2 diabetes (Beijing Community Diabetes Study 23).
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ABSTRACT:
SUBMITTER: Yang GR
PROVIDER: S-EPMC8097072 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundAlthough studies have shown that waist circumference (WC) is positively associated with an increased risk of cardiovascular diseases among the normal population, few studies have investigated WC in patients with type-2 diabetes mellitus (T2DM).MethodsThis was a post hoc analysis of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study. The Cox proportional hazards models was used to investigate the relationship between WC and major adverse cardiovascular events (MACEs) in T2DM patients with cardiovascular disease (CVD) or high risk factors of CVD.ResultsA total of 10,251 T2DM patients (6299 men [61.4%], 3952 women [38.6%]) were included in our analysis. The mean age was 64.0 ± 7.53 years. After a mean follow-up at 9.2 ± 2.4 years later, 1804 patients (event rate of 23 per 1000 person-years) had developed MACEs. MACEs rates in men and women were 18.0 and 26.0 events per 1000 person-years, respectively. After multivariable adjustment, each increase in WC of 1 SD increased the risk of MACEs (HR: 1.10, 95% CI 1.04-1.17; P < 0.01) in men, with a non-significant increase in MACEs (HR: 1.04, 95% CI 0.95-1.13; P = 0.40) in women. Compared with those in the first quartile of WC, male patients in the fourth quartile of WC had a hazard ratio (HR) of 1.24 (95% CI 1.05-1.46) for MACEs; female patients in the fourth quartile of WC had an HR of 1.22 (95% CI 0.96-1.56) for MACEs.ConclusionsHigher WC is associated with increased risks of MACEs in male but not female T2DM patients. Trial registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT00000620).
| S-EPMC7093979 | biostudies-literature
Project description:BackgroundObesity is associated with cardiovascular diseases and is a risk factor for all-cause mortality. Until now, the associations between abdominal obesity and mortality or cardiovascular disease (CVD) incidence have not been conclusive. We aimed to evaluate the associations between waist circumference (WC) and mortality or CVD incidence in a general Korean population.MethodsWe analyzed a total of 204,068 adults older than 40 years of age who had undergone a national health examination at least once from 2009 to 2018 in the Korean National Health Insurance Service Cohort. WC was divided into five categories (< 80, 80-84.9, 85-89.9, 90-94.9, ≥ 95 cm). Hazard ratios for death and CVD incidence were calculated using Cox proportional hazards models.ResultsIn men, WC and overall mortality showed a reverse J-shaped association. In women, the association between WC and overall mortality was not significant. For both men and women, WC was not associated with the risk of cardiovascular mortality. Contrary to the mortality trend, CVD incidence was positively associated with WC in both men and women, and the risk of the CVD incidence was the lowest in subjects with a WC < 80 cm.ConclusionsWC exhibited a significant J-shaped association with overall mortality in men, where subjects who had central obesity showed a lower rate of mortality than those in the lowest or highest WC group. The risk of incident CVD showed a positive association with central obesity, where the lowest risk was observed for subjects in the lowest WC group in a general Korean population.
| S-EPMC9045645 | biostudies-literature
Project description:ObjectivesTo predict in an Australian Aboriginal community, the 10-year absolute risk of type 2 diabetes associated with waist circumference and age on baseline examination.MethodA sample of 803 diabetes-free adults (82.3% of the age-eligible population) from baseline data of participants collected from 1992 to 1998 were followed-up for up to 20 years till 2012. The Cox-proportional hazard model was used to estimate the effects of waist circumference and other risk factors, including age, smoking and alcohol consumption status, of males and females on prediction of type 2 diabetes, identified through subsequent hospitalisation data during the follow-up period. The Weibull regression model was used to calculate the absolute risk estimates of type 2 diabetes with waist circumference and age as predictors.ResultsOf 803 participants, 110 were recorded as having developed type 2 diabetes, in subsequent hospitalizations over a follow-up of 12633.4 person-years. Waist circumference was strongly associated with subsequent diagnosis of type 2 diabetes with P<0.0001 for both genders and remained statistically significant after adjusting for confounding factors. Hazard ratios of type 2 diabetes associated with 1 standard deviation increase in waist circumference were 1.7 (95%CI 1.3 to 2.2) for males and 2.1 (95%CI 1.7 to 2.6) for females. At 45 years of age with baseline waist circumference of 100 cm, a male had an absolute diabetic risk of 10.9%, while a female had a 14.3% risk of the disease.ConclusionsThe constructed model predicts the 10-year absolute diabetes risk in an Aboriginal Australian community. It is simple and easily understood and will help identify individuals at risk of diabetes in relation to waist circumference values. Our findings on the relationship between waist circumference and diabetes on gender will be useful for clinical consultation, public health education and establishing WC cut-off points for Aboriginal Australians.
| S-EPMC4395219 | biostudies-literature
Project description:We sought to assess the relationship between the metabolic syndrome, abdominal obesity, and glucose deterioration amongst patients with type 2 diabetes. Our prospective cohort consisted of 164 adult patients with established diabetes who have a history of poor glycemic control, have just completed an intensive intervention aimed at improved control, and have demonstrated reduced HbA1c prior to enrollment. Waist circumference and presence of metabolic syndrome were assessed at baseline, and patients were followed up (median 24 months) for assessment of the study outcome, namely, time-to-hyperglycemic relapse, predefined as HbA1c >8% and >1% rise over baseline. Kaplan-Meier estimates of relapse-free glucose maintenance and multivariable Cox regression models were used for quantifying the independent effects of the metabolic syndrome and waist circumference on risk of glucose deterioration. The mean baseline waist circumference was 42.9 5.5 inches. Prevalence of the metabolic syndrome was 80%. During follow-up, 39 patients (24%) experienced hyperglycemic relapse. The metabolic syndrome was not associated with time-to-relapse (P = 0.15). The waist circumference component by itself, however, was associated with increased likelihood of hyperglycemic relapse with an unadjusted hazard ratio of 3.4 (95% confidence interval (CI) 1.2-9.7) and a hazard ratio of 3.2 (95% CI 1.1-9.1) after adjusting for age, gender, insulin use, weight change, and physical activity level. The National Cholesterol Education Program Adult Treatment Panel III (NCEP ATPIII) metabolic syndrome had limited ability to predict glucose deterioration in this type 2 diabetes cohort. Waist circumference by itself, however, is a strong predictor of future glucose control, and may be a parsimonious tool for risk stratification. BMI may also be a useful predictive tool.
| S-EPMC4131716 | biostudies-other
Project description:Waist circumference is associated with type 2 diabetes (T2D) and cognition, yet the relationship between waist circumference and cognition in individuals with T2D is not well understood.We studied the relationship of waist circumference with five cognitive outcomes (executive functioning, language/semantic categorization, attention/working memory, episodic memory, and an overall cognition measure) in 845 cognitively normal elderly with type 2 diabetes (T2D).In women, waist circumference was correlated with significantly lower language and/or semantic categorization performance (P < .0001), executive functioning (P = .026), and overall cognition (P = .003) after controlling for age, education, BMI, and cardiovascular, diabetes-related, APOE ?4, and inflammatory potential confounders. Attention/working memory (P = .532) and episodic memory (P = .144) were not associated with waist circumference. These correlations were not found in men.These results suggest that central adiposity in elderly women with T2D may increase their risk for dementia.
| S-EPMC5753411 | biostudies-literature
Project description:BackgroundsThe association between weight gain and the incidence of type 2 diabetes is well known. The aim of our study was to investigate the relationship between change in waist circumference (WC) and type 2 diabetes incidence.MethodsThe participants in the Suita Study, a population-based cohort study in an urban area of Japan, underwent a baseline survey between 1989 and 1994 (Exam 1) and were examined at follow-up every 2 years. We performed a 9.3-year cohort study of 946 men and 1327 women with no history of diabetes who underwent Exam 1 and Exam 2 (between 1997 and 1999). Participants were stratified by sex and median WC at Exam 1, and, in each stratum, participants were further classified into three categories by tertile of WC change per year between Exam 1 and Exam 2. Hazard ratios (HRs) and 95% confidence intervals (CIs) for type 2 diabetes incidence were calculated by Cox proportional hazard models. The endpoints were first diagnosis of type 2 diabetes or March 2011.ResultsDuring follow-up, 287 participants developed type 2 diabetes. In both sexes with median WC or higher, participants in the highest tertile of WC change had a significantly higher risk of developing type 2 diabetes. Multivariable adjusted HRs were 1.84 (95% CI, 1.10-3.08) in men and 2.30 (95% CI, 1.31-4.04) in women. No significant association was observed among participants with WC below median.ConclusionsPreventing WC gain is important in preventing type 2 diabetes in the Japanese population, especially among individuals with a relatively high WC.
| S-EPMC4483375 | biostudies-literature
Project description:We aimed to determine the genetic and environmental correlation between various anthropometric indexes and incident Type 2 diabetes with a focus on waist circumference.We used the data on extended Mexican-American families (808 subjects, 7617.92 person-years follow-up) from the San Antonio Family Heart Study and estimated the genetic and environmental correlations of 16 anthropometric indexes with the genetic liability of incident Type 2 diabetes. We performed bivariate trait analyses using the solar software package.All 16 anthropometric indexes were significantly heritable (range of heritabilities 0.24-0.99). Thirteen indexes were found to have significant environmental correlation with the liability of incident Type 2 diabetes. In contrast, only anthropometric indexes consisting of waist circumference (waist circumference, waist-hip ratio and waist-height ratio) were significantly genetically correlated (genetic correlation coefficients: 0.45, 0.55 and 0.44, respectively) with the liability of incident Type 2 diabetes. We did not observe such a correlation for BMI.Waist circumference as a predictor of future Type 2 diabetes is supported by the finding that they share common genetic influences.
| S-EPMC3849209 | biostudies-literature
Project description:Despite considerable evidence demonstrating that waist circumference (WC) is independently associated with cardiovascular disease (CVD) and/or all-cause mortality, whether the addition of WC improves risk prediction models is unclear. The objective was to evaluate the improvement in risk prediction with the addition of WC, alone or in combination with BMI, to the Framingham Risk Score (FRS) and a population specific model. 34,377 men and 9,477 women aged 20 to 79 years who completed a baseline examination at the Cooper Clinic (Dallas, TX) during 1977-2003 and enrolled in the Aerobics Center Longitudinal Study (ACLS). WC was measured at the level of the umbilicus and expressed as a continuous variable. Deaths among participants were identified using the National Center for Health Statistics National Death Index. A total of 728 fatal cardiovascular disease (CVD) events occurred over a mean follow-up period of 13.1 ± 7.5 years. WC was significantly higher in CVD decedents (P = .002). The FRS C-statistic for fatal CVD in men was 0.836 (0.816-0.855) and 0.883 (0.851-0.915) in women. The addition of WC did not improve the C-statistic in men (0.831 (0.809-0.853)) or women (0.883 (0.850-0.916)). Similar findings were observed for non-fatal CVD and all-cause mortality, and when WC was added to a population specific model. Upon adding WC, the net-reclassification index was 0.024 with an integrated discrimination improvement of -0.0004. The addition of WC, alone or in combination with BMI, did not substantively improve risk prediction for CVD or all-cause mortality compared to the Framingham Risk Score or a population specific model.
| S-EPMC7531816 | biostudies-literature
Project description:ObjectiveTo investigate whether waist circumference (WC), calf circumference (CC), and waist-to-calf ratio (WCR) are associated with carotid atherosclerosis in patients with type 2 diabetes.Research design and methodsThis was an observational study performed in 3,694 Korean patients with type 2 diabetes. Anthropometric measures and carotid ultrasound were performed on each subject. Carotid atherosclerosis was defined as having a clearly isolated focal plaque or mean carotid intima-media thickness (CIMT) ?1.1 mm.ResultsCIMT and the frequency of carotid atherosclerosis were higher with increasing WC quartiles and decreasing CC quartiles. There was an augmentative effect of CC and WC on the frequency of carotid atherosclerosis, which was dramatically higher in both the highest WC quartile and lowest CC quartile. However, except for the relationship between the quartile of CC with the frequency of carotid atherosclerosis in men, those associations disappeared after adjusting for potential confounders. In contrast, WCR was significantly related to CIMT (only in women) and carotid atherosclerosis, even after adjustment (adjusted odds ratio for carotid atherosclerosis for the highest quartile of WCR compared with the lowest quartile being 1.178 [95% CI 1.026-1.353] and 1.276 [1.053-1.545] in men and women, respectively).ConclusionsA low CC and high WC seems to be associated with a carotid atherosclerotic burden in Korean diabetic patients. In particular, compared with each circumference, WCR is independently associated with carotid atherosclerosis. However, the cross-sectional nature of the study limits conclusions regarding the direction or causality. Further longitudinal study is warranted in this and other ethnic groups.
| S-EPMC3161258 | biostudies-literature
Project description:AimsTo determine the waist circumference (WC) thresholds for the prediction of incident dysglycaemia and type 2 diabetes (T2D) in Black South African (SA) men and women and to compare these to the advocated International Diabetes Federation (IDF) Europid thresholds.Materials and methodsIn this prospective study, Black SA men (n = 502) and women (n = 527) from the Middle-aged Sowetan Cohort study who had normal or impaired fasting glucose at baseline (2011-2015) were followed up until 2017 to 2018. Baseline measurements included anthropometry, blood pressure and fasting glucose, HDL cholesterol and triglyceride concentrations. At follow-up, glucose tolerance was assessed using an oral glucose tolerance test. The Youden index was used to determine the optimal threshold of WC to predict incident dysglycaemia and T2D.ResultsIn men, the optimal WC threshold was 96.8 cm for both dysglycaemia and T2D (sensitivity: 56% and 70%; specificity: 74% and 70%, respectively), and had higher specificity (P < 0.001) than the IDF threshold of 94 cm. In women, the optimal WC threshold for incident dysglycaemia was 91.8 cm (sensitivity 86%, specificity 37%) and for T2D it was 95.8 cm (sensitivity 85%, specificity 45%), which had lower sensitivity, but higher specificity to predict incident dysglycaemia and T2D than the IDF threshold of 80 cm (sensitivity: 97% and 100%; specificity: 12% and 11%, respectively)).ConclusionsWe show for the first time using prospective cohort data from Africa that the IDF Europid WC thresholds are not appropriate for an African population, and show that African-specific WC thresholds perform better than the IDF Europid thresholds to predict incident dysglycaemia and T2D.
| S-EPMC9305761 | biostudies-literature