Waist circumference is associated with major adverse cardiovascular events in male but not female patients with type-2 diabetes mellitus

Xing, Zhenhua; Peng, Zhenyu; Wang, Xiaopu; Zhu, Zhaowei; Pei, Junyu; Hu, Xinqun; Chai, Xiangping

doi:10.1186/s12933-020-01007-6

Cited by 21 publications

(11 citation statements)

References 49 publications

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“…We also noted that combining WC and HGS/BW, a potential proxy fat: muscle index, had a summative effect on the risk of having a higher MetS score. Our cross-sectional analysis showed a stronger association between a higher MetS score and WC than BMI, confirming previous studies showing that in Latin-American and Chinese population, WC is a stronger predictor of major cardiovascular events such as myocardial infarction or stroke than BMI, particularly in men [8,21]. Similarly, in diabetic Chinese adults, high visceral fat measured by a visceral adiposity index and WC were associated with a higher prevalence of diabetic kidney disease and CVD compared to BMI [22].…”

Section: Combining Adiposity and Muscle Strength Measurements Increases The Prediction Of Metabolic Alterationssupporting

confidence: 91%

The prediction of Metabolic Syndrome alterations is improved by combining waist circumference and handgrip strength measurements compared to either alone

López‐López

Cohen

Ney-Salazar

et al. 2021

Cardiovasc Diabetol

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Background Adiposity is a major component of the metabolic syndrome (MetS), low muscle strength has also been identified as a risk factor for MetS and for cardiovascular disease. We describe the prevalence of MetS and evaluate the relationship between muscle strength, anthropometric measures of adiposity, and associations with the cluster of the components of MetS, in a middle-income country. Methods MetS was defined by the International Diabetes Federation criteria. To assess the association between anthropometric variables (waist circumference (WC), waist-to-hip ratio (W/H), body mass index (BMI)), strength (handgrip/kg bodyweight (HGS/BW)) and the cluster of MetS, we created a MetS score. For each alteration (high triglycerides, low HDLc, dysglycemia, or high blood pressure) one point was conferred. To evaluate the association an index of fat:muscle and MetS score, participants were divided into 9 groups based on combinations of sex-specific tertiles of WC and HGS/BW. Results The overall prevalence of MetS in the 5,026 participants (64% women; mean age 51.2 years) was 42%. Lower HGS/BW, and higher WC, BMI, and W/H were associated with a higher MetS score. Amongst the 9 HGS/BW:WC groups, participants in the lowest tertile of HGS/BW and the highest tertile of WC had a higher MetS score (OR = 4.69 in women and OR = 8.25 in men;p < 0.01) compared to those in the highest tertile of HGS/BW and in the lowest tertile of WC. Conclusion WC was the principal risk factor for a high MetS score and an inverse association between HGS/BW and MetS score was found. Combining these anthropometric measures improved the prediction of metabolic alterations over either alone.

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Section: Combining Adiposity and Muscle Strength Measurements Increases The Prediction Of Metabolic Alterationssupporting

confidence: 91%

The prediction of Metabolic Syndrome alterations is improved by combining waist circumference and handgrip strength measurements compared to either alone

López‐López

Cohen

Ney-Salazar

et al. 2021

Cardiovasc Diabetol

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show abstract

“…The result of a cross-sectional study has shown that obesity and type 2 diabetes have an additive effect on left ventricular remodeling in normotensive patients ( 28 ). A recent study of patients with type-2 DM showed that compared with those in the first quartile of WC, male patients in the fourth quartile of WC (WC ≥ 126) had an HR of 1.24 (95% CI: 1.05–1.46) for major adverse cardiovascular events (MACEs); female patients in the fourth quartile of WC (WC ≥ 122 cm) had an HR of 1.22 (95% CI: 0.96–1.56) for MACEs ( 29 ). Our results suggested that patients with higher levels of WC coexisted with diabetes had the worst outcome, the association is still significant after adjustment of other clinical confounders.…”

Section: Discussionmentioning

confidence: 99%

Risk for Cardiovascular Death Associated With Waist Circumference and Diabetes: A 9-Year Prospective Study in the Wan Shou Lu Cohort

Zhu

Wang

2022

Front. Cardiovasc. Med.

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BackgroundIt has been reported that obesity and diabetes are both risk factors for the development of cardiovascular diseases (CVDs). However, recent articles reported that compared with body mass index, waist circumference (WC) can better reflect obesity, more closely related to visceral fat tissue which is positively associated with an increased risk of cardiovascular death. Moreover, few studies have investigated the prognostic value of both WC and diabetes during a long-term follow-up. We aimed to investigate whether the higher level of WC measurements and diabetes were able to predict cardiovascular mortality in the general population.MethodsIn this prospective cohort study, a total of 1,521 consecutive subjects free of clinical CVD were included. The endpoint was cardiovascular death. The Kaplan–Meier method and Cox regression models were used to evaluate the cumulative risk of the outcome at different WC levels with or without diabetes.ResultsDuring a median follow-up of 9.2 years, 265 patients died due to cardiovascular conditions. Kaplan–Meier survival estimates indicated that the patients with higher levels of WC (WC > 94 cm) coexisted with diabetes had a significantly increased risk of cardiovascular death (log-rank p < 0.05). After adjustment for potential confounders, multiple COX regression models showed that the incidence of cardiovascular death was significantly higher when patients with high WC coexisted with diabetes mellitus (hazard ratio: 3.78; 95% CI: 3.35–3.98; p < 0.001).ConclusionPatients with high WC and diabetes represent a high-risk population for cardiovascular death. WC and diabetes may provide incremental prognostic value beyond traditional risks factors.

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“…It has been found that people with higher WC levels have 5–7 times higher chances of having T2DM. 45 …”

Section: Discussionmentioning

confidence: 99%

Prevalence of overweight and obesity amongst patients with diabetes and their non-diabetic family members in Senwabarwana, Limpopo province, South Africa

Mphasha

Skaal

Mothiba

2022

South African Family Practice

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Background: Diabetes remains a public health concern and the second cause of mortality in South Africa. Family history of diabetes increases risk of developing diabetes. Obesity amongst patients is associated with comorbidity, whilst amongst non-diabetic family members it is associated with developing diabetes. This study aimed at determining prevalence of overweight and obesity amongst patients with diabetes and non-diabetic family members.Methods: A quantitative, cross-sectional descriptive study was conducted on 200 patients and 200 non-diabetic family members were selected using systematic random sampling from rural clinics of Senwabarwana. Data were collected using close-ended questionnaires and anthropometric measurements. Body mass index (BMI) and waist circumference were measured and interpreted according to World Health Organization guidelines. Data were analysed using Statistical Package for Social Sciences, using both descriptive and inferential statistics. Chi-square test was used to calculate associations at 95% confidence interval where a p-value of 0.05 was considered statistically significant.Results: Most patients (75.5%) had comorbidities and hypertension was most prevalent (89.0%). Over half of the patients (57.0%) and 38.0% of family members were obese. Most patients (75.0%) and 58.0% of family members had abdominal obesity.Conclusion: Patients with diabetes suffer from comorbidities are overweight and obese whilst evidence from various studies suggest that non-diabetic family members are at added risk of developing diabetes because of higher BMI and abdominal obesity. There is an urgent need to create a conducive environment that discourages sedentary behaviours through lifestyle modifications using the family centred approach, and involve family members in the care of patients.

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Waist circumference is associated with major adverse cardiovascular events in male but not female patients with type-2 diabetes mellitus

Cited by 21 publications

References 49 publications

The prediction of Metabolic Syndrome alterations is improved by combining waist circumference and handgrip strength measurements compared to either alone

The prediction of Metabolic Syndrome alterations is improved by combining waist circumference and handgrip strength measurements compared to either alone

Risk for Cardiovascular Death Associated With Waist Circumference and Diabetes: A 9-Year Prospective Study in the Wan Shou Lu Cohort

Prevalence of overweight and obesity amongst patients with diabetes and their non-diabetic family members in Senwabarwana, Limpopo province, South Africa

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