Prediction of cardiovascular events with consideration of general and central obesity measures in diabetic adults: results of the 8.4-year follow-up.
BACKGROUND
Obesity is one of the most important cardiovascular disease (CVD) risk factors among diabetic populations. We evaluated the ability of different anthropometric measures for predicting CVD among type 2 diabetic patients.


METHODS
The study consisted of 411 men and 599 women, aged ≥30 years, free of CVD at baseline with a median follow-up of 8.4 years. The adjusted hazard ratios (HRs) for CVD were calculated for a 1 standard deviation change in body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) using Cox proportional regression analysis.


RESULTS
A total of 188 CVD events occurred (men, 90; women, 98). In women, in confounder-adjusted analysis [age, fasting plasma glucose (instead of glycosylated hemoglobin), and positive family history of CVD], WHR was associated with incident CVD [1.32 (1.06-1.65)], followed by WC and WHtR, which were marginally significant (P=0.06 and 0.08, respectively); after adjustment for hypertension and hypercholesterolemia, only WHR predicted CVD significantly. In men, the confounder-adjusted (age, fasting plasma glucose, and aspirin use) HR to predict CVD was significant only for WHR [HR 1.21(1.00-1.48)].


CONCLUSIONS
This study showed WHR was the most powerful predictor of CVD among anthropometric measures, followed by WHtR, in diabetic population.
Prevention of Metabolic Disorders Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Shayesteh
S
Khalili
Masumeh
M
Hatami
Farzad
F
Hadaegh
Farhad
F
Sheikholeslami
Fereidoun
F
Azizi
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D016009:Chi-Square Distribution; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology*; D016002:Discriminant Analysis; D005260:Female; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000175:diagnosis / Q000453:epidemiology*; D011237:Predictive Value of Tests; D015995:Prevalence; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D055105:Waist Circumference; D049629:Waist-Hip Ratio