TY - JOUR
T1 - Associations between general and abdominal adiposity and mortality in individuals with diabetes mellitus
AU - Sluik, Diewertje
AU - Boeing, Heiner
AU - Montonen, Jukka
AU - Pischon, Tobias
AU - Kaaks, Rudolf
AU - Teucher, Birgit
AU - Tjønneland, Anne
AU - Halkjaer, Jytte
AU - Berentzen, Tina L.
AU - Overvad, Kim
AU - Arriola, Larraitz
AU - Ardanaz, Eva
AU - Bendinelli, Benedetta
AU - Grioni, Sara
AU - Tumino, Rosario
AU - Sacerdote, Carlotta
AU - Mattiello, Amalia
AU - Spijkerman, Annemieke M.W.
AU - Van Der A, Daphne L.
AU - Beulens, Joline W.
AU - Van Der Schouw, Yvonne T.
AU - Nilsson, Peter M.
AU - Hedblad, Bo
AU - Rolandsson, Olov
AU - Franks, Paul W.
AU - Nöthlings, Ute
PY - 2011/7/1
Y1 - 2011/7/1
N2 - 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.
AB - 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.
KW - adiposity
KW - body mass index
KW - diabetes complications
KW - diabetes mellitus
KW - mortality
KW - waist circumference
KW - waist-hip ratio
UR - http://www.scopus.com/inward/record.url?scp=79959644426&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/aje/kwr048
DO - https://doi.org/10.1093/aje/kwr048
M3 - Article
C2 - 21616928
SN - 0002-9262
VL - 174
SP - 22
EP - 34
JO - American journal of epidemiology
JF - American journal of epidemiology
IS - 1
ER -