Associations between general and abdominal obesity and incident diabetic neuropathy in participants with type 2 diabetes mellitus

Abstract

Background: Previous epidemiological evidence on the sex-specific association of obesity, particularly abdominal obesity, as reflected by larger waist circumference (WC), with incident diabetic neuropathy (DN) remains limited. Methods: We used data from a patient cohort with a median 10-year history of type 2 diabetes mellitus at the time of recruitment. A composite outcome of four types of predefined DN (Neuro 1-4) was used as the outcome of interest. Because of sex differences in abdominal obesity, analyses were conducted separately for men and women. Results: Among the 7442 participants (4551 men and 2891 women) recruited in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study, 3999 cases of incident DN were documented (2529 in men and 1470 in women). Larger WCs were associated with a higher risk of DN among both men and women. Compared with the lowest quintile, the hazard ratio (HR) for the highest quintile was 1.30 (95% CI 1.13-1.49) among men (P trend <.001). For women, the HR for the highest vs lowest quintile was 1.25 (95% CI 1.04-1.51) (P trend <.001). A linear relationship between WC and DN was observed in men, and in women, the risk of DN increased as the WC quintile increased before it appeared to plateau. The relationship between body mass index and incident DN was similar to the results observed for WC. Conclusion: General and abdominal obesity were both associated with an increased risk of incident DN among individuals with type 2 diabetes mellitus, regardless of sex.

Association of visceral adiposity index with incident nephropathy and retinopathy: a cohort study in the diabetic population

“…Abdominal obesity is recognized as one of the important risk factors of cardiometabolic diseases [ 4 ], diabetes [ 5 ], and diabetic complications [ 6 ]. Interestingly, several studies reported that the distribution of adipose tissue rather than the total amount is more crucial in the development of vascular complications [ 7 ].…”

Anthropometric Measures and Incident Diabetic Nephropathy in Participants With Type 2 Diabetes Mellitus

“…However, most of these studies did not assess the association between obesity indexes and renal outcome stratified by sex. As an indicator of upper body adipose tissue distribution and abdominal obesity, waist circumference (WC) and waist-to-height ratio (WHtR) are considered a potential anthropometric measure of obesity ( 18 ). Thus, in the present study, we sought to assess the association between obesity (defined by WC, WHtR, and BMI) and diabetic nephropathy (DN) separately among men and women with T2DM.…”

“…In this context, we sought to concurrently investigate the association of WC, WHtR, and BMI with incident DN using data from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study, which was a randomized, multicenter, double 2 × 2 factorial trial in 10,251 patients with T2DM ( 18 ).…”

Association of Predicted Lean Body Mass and Fat Mass With Incident Diabetic Nephropathy in Participants With Type 2 Diabetes Mellitus: A Post Hoc Analysis of ACCORD Trial

“…The prediction equations mentioned above permit studies of LBM or FM without dual-energy x-ray absorptiometry or imaging technologies. In this context, we conducted a post hoc analysis to investigate the association of predicted LBM and FM with incident DN using data from the ACCORD study, which was a randomized, multicenter, double 2 × 2 factorial trial in 10,251 patients with type 2 diabetes mellitus (T2DM) ( 22 ).…”