title: Associations between general and abdominal adiposity and mortality in individuals with diabetes mellitus.
abstract: Individuals with diabetes mellitus are advised to achieve a healthy weight to prevent complications. However, fat mass distribution has hardly been investigated as a risk factor for diabetes complications. The authors studied associations between body mass index, waist circumference, waist/hip ratio, and waist/height ratio and mortality among individuals with diabetes mellitus. Within the European Prospective Investigation into Cancer and Nutrition, a subcohort was defined as 5,435 individuals with a confirmed self-report of diabetes mellitus at baseline in 1992-2000. Participants were aged 57.3 (standard deviation, 6.3) years, 54% were men, the median diabetes duration was 4.6 (interquartile range, 2.0-9.8) years, and 22% of the participants used insulin. Body mass index, as indicator of general obesity, was not associated with higher mortality, whereas all measurements of abdominal obesity showed a positive association. Associations generally were slightly weaker in women. The strongest association was observed for waist/height ratio: In the fifth quintile, the hazard rate ratio was 1.88 (95% confidence interval: 1.33, 2.65) for men and 2.46 (95% confidence interval: 1.46, 4.14) for women. Measurements of abdominal, but not general, adiposity were associated with higher mortality in diabetic individuals. The waist/height ratio showed the strongest association. Respective indicators might be investigated in risk prediction models.
authors: Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrucke, Arthur-Scheunert-Allee 114–116, 14558 Nuthetal, Germany. diewertje.sluik@dife.de
authors: Diewertje
authors: D
authors: Sluik
authors: Heiner
authors: H
authors: Boeing
authors: Jukka
authors: J
authors: Montonen
authors: Tobias
authors: T
authors: Pischon
authors: Rudolf
authors: R
authors: Kaaks
authors: Birgit
authors: B
authors: Teucher
authors: Anne
authors: A
authors: Tjønneland
authors: Jytte
authors: J
authors: Halkjaer
authors: Tina L
authors: TL
authors: Berentzen
authors: Kim
authors: K
authors: Overvad
authors: Larraitz
authors: L
authors: Arriola
authors: Eva
authors: E
authors: Ardanaz
authors: Benedetta
authors: B
authors: Bendinelli
authors: Sara
authors: S
authors: Grioni
authors: Rosario
authors: R
authors: Tumino
authors: Carlotta
authors: C
authors: Sacerdote
authors: Amalia
authors: A
authors: Mattiello
authors: Annemieke M W
authors: AM
authors: Spijkerman
authors: Daphne L
authors: DL
authors: van der A
authors: Joline W
authors: JW
authors: Beulens
authors: Yvonne T
authors: YT
authors: van der Schouw
authors: Peter M
authors: PM
authors: Nilsson
authors: Bo
authors: B
authors: Hedblad
authors: Olov
authors: O
authors: Rolandsson
authors: Paul W
authors: PW
authors: Franks
authors: Ute
authors: U
authors: Nöthlings