Advanced

Associations Between General and Abdominal Adiposity and Mortality in Individuals With Diabetes Mellitus

Sluik, Diewertje; Boeing, Heiner; Montonen, Jukka; Pischon, Tobias; Kaaks, Rudolf; Teucher, Birgit; Tjonneland, Anne; Halkjaer, Jytte; Berentzen, Tina L. and Overvad, Kim, et al. (2011) In American Journal of Epidemiology 174(1). p.22-34
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... (More)
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. (Less)
Please use this url to cite or link to this publication:
@article{e59b6ce4-a869-4b71-979a-64c6b5150fb8,
  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.},
  author       = {Sluik, Diewertje and Boeing, Heiner and Montonen, Jukka and Pischon, Tobias and Kaaks, Rudolf and Teucher, Birgit and Tjonneland, Anne and Halkjaer, Jytte and Berentzen, Tina L. and Overvad, Kim and Arriola, Larraitz and Ardanaz, Eva and Bendinelli, Benedetta and Grioni, Sara and Tumino, Rosario and Sacerdote, Carlotta and Mattiello, Amalia and Spijkerman, Annemieke M. W. and van der A, Daphne L. and Beulens, Joline W. and van der Schouw, Yvonne T. and Nilsson, Peter and Hedblad, Bo and Rolandsson, Olov and Franks, Paul and Noethlings, Ute},
  issn         = {0002-9262},
  keyword      = {adiposity,body mass index,diabetes complications,diabetes mellitus,mortality,waist circumference,waist-hip ratio},
  language     = {eng},
  number       = {1},
  pages        = {22--34},
  publisher    = {Oxford University Press},
  series       = {American Journal of Epidemiology},
  title        = {Associations Between General and Abdominal Adiposity and Mortality in Individuals With Diabetes Mellitus},
  url          = {http://dx.doi.org/10.1093/aje/kwr048},
  volume       = {174},
  year         = {2011},
}