Associations between general and abdominal adiposity and mortality in individuals with diabetes mellitus

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Item Type:	Article
Title:	Associations between general and abdominal adiposity and mortality in individuals with diabetes mellitus
Creators Name:	Sluik, D., Boeing, H., Montonen, J., Pischon, T., Kaaks, R., Teucher, B., Tjoenneland, A., Halkjaer, J., Berentzen, T.L., Overvad, K., Arriola, L., Ardanaz, E., Bendinelli, B., Grioni, S., Tumino, R., Sacerdote, C., Mattiello, A., Spijkerman, A.M., van der A, D.L., Beulens, J.W., van der Schouw, Y.T., Nilsson, P.M., Hedblad, B., Rolandsson, O., Franks, P.W. and Noethlings, U.
Abstract:	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.
Keywords:	Adiposity, Body Mass Index, Diabetes Complications, Diabetes Mellitus, Mortality, Waist Circumference, Waist-Hip Ratio, Abdominal Fat, Abdominal Obesity, Adult, Body Height, Cohort Studies, Confidence Intervals, Europe, Life Style, Multivariate Analysis, Odds Ratio, Prevalence, Proportional Hazards Models, Questionnaires, Risk Factors, Type 2 Diabetes Mellitus
Source:	American Journal of Epidemiology
ISSN:	0002-9262
Publisher:	Oxford University Press
Volume:	174
Number:	1
Page Range:	22-34
Date:	1 July 2011
Official Publication:	https://doi.org/10.1093/aje/kwr048
PubMed:	View item in PubMed

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