Associations between general and abdominal adiposity and mortality in individuals with diabetes mellitus
2011 (English)In: American Journal of Epidemiology, ISSN 0002-9262, E-ISSN 1476-6256, Vol. 174, no 1, 22-34 p.Article in journal (Refereed) Published
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.
Place, publisher, year, edition, pages
Cary: Oxford University Press, 2011. Vol. 174, no 1, 22-34 p.
adiposity, body mass index, diabetes complications, diabetes mellitus, mortality, waist circumference, waist-hip ratio
Public Health, Global Health, Social Medicine and Epidemiology
IdentifiersURN: urn:nbn:se:umu:diva-44343DOI: 10.1093/aje/kwr048ISI: 000292046300004PubMedID: 21616928OAI: oai:DiVA.org:umu-44343DiVA: diva2:420254