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Waist-to-height ratio has a stronger association with cardiovascular risks than waist circumference, waist-hip ratio and body mass index in type 2 diabetes

  • Author Footnotes
    1 These authors equally contributed to this work.
    Jiang-Feng Ke
    Footnotes
    1 These authors equally contributed to this work.
    Affiliations
    Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, 600 Yishan Road, 200233 Shanghai, China
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  • Author Footnotes
    1 These authors equally contributed to this work.
    Jun-Wei Wang
    Footnotes
    1 These authors equally contributed to this work.
    Affiliations
    Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, 600 Yishan Road, 200233 Shanghai, China
    Search for articles by this author
  • Author Footnotes
    1 These authors equally contributed to this work.
    Jun-Xi Lu
    Footnotes
    1 These authors equally contributed to this work.
    Affiliations
    Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, 600 Yishan Road, 200233 Shanghai, China
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  • Zhi-Hui Zhang
    Affiliations
    Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, 600 Yishan Road, 200233 Shanghai, China
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  • Yun Liu
    Affiliations
    Department of Information, the First Affiliated Hospital of Nanjing Medical University, Department of Medical Information, School of Biomedical Engineering and Informatics, Nanjing Medical University, Jiangsu, China
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  • Lian-Xi Li
    Correspondence
    Corresponding author.
    Affiliations
    Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, 600 Yishan Road, 200233 Shanghai, China
    Search for articles by this author
  • Author Footnotes
    1 These authors equally contributed to this work.
Published:December 01, 2021DOI:https://doi.org/10.1016/j.diabres.2021.109151

      Abstract

      Aims

      To compare the associations between four anthropometric indices including waist-to-height ratio (WHtR), waist circumference (WC), waist-hip-ratio (WHR) and body mass index (BMI) and cardio-cerebrovascular events (CCBVEs) in Chinese T2DM patients.

      Methods

      The associations of four anthropometric measures with CCBVEs and metabolic syndrome (MetS) were compared by multiple regression model in 3108 T2DM patients. CCBVEs was defined as a history of myocardial infarction, angina, angioplasty, coronary artery bypass surgery, transient ischemic attack, ischemic or hemorrhagic stroke.

      Results

      After controlling for age, sex and diabetes duration, the prevalence of CCBVEs and MetS significantly increased across the WHtR, WC, WHR and BMI quartiles in T2DM patients, respectively. However, when controlling for these four anthropometric measurements together, although four anthropometric measures were closely associated with MetS prevalence, only WHtR quartile was significantly associated with CCBVEs prevalence (6.5%, 13.8%, 16.9% and 21.3%, p < 0.001 for trend). After adjusting for multiple confounders including four anthropometric parameters, a regression analysis revealed that only WHtR was independently and positively associated with the presence of CCBVEs (p = 0.029).

      Conclusions

      Compared with WC, WHR and BMI, WHtR have a stronger association with CCBVEs in T2DM subjects. WHtR maybe a better indicator than other anthropometric measurements for evaluating cardiovascular risks in T2DM.
      T2DM (type 2 diabetes mellitus), WHtR (waist-to-height ratio), WC (waist circumference), WHR (waist-hip-ratio), BMI (body mass index), CCBVEs (cardio-cerebrovascular events), CBVEs (cerebrovascular events), CVEs (cardiovascular events), MetS (metabolic syndrome), LLDs (ipid-lowering drugs), AHAs (antihypertensive agents), APAs (anti-platelet agents), IIAs (insulin analogues), SBP (systolic blood pressure), DBP (diastolic blood pressure), WBC (white blood cell), HbA1c (glycosylated hemoglobin A1c), TG (triglycerides), TC (total cholesterol), HDL-C (high-density lipoprotein cholesterol), LDL-C (low-density lipoprotein cholesterol), HOMA2-IR (homeostasis model assessment for insulin resistance)

      Keywords

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