(14-06-11) Associations Between General and Abdominal Adiposity and Mortality in Individuals With Diabetes Mellitus.

Sluik D, Boeing H, Montonen J, Pischon T, Kaaks R, Teucher B, Tj?nneland A,
Halkjaer J, Berentzen TL, Overvad K, Arriola L, Ardanaz E, Bendinelli B, Grioni
S, Tumino R, Sacerdote C, Mattiello A, Spijkerman AM, van der A DL, Beulens JW,
van der Schouw YT, Nilsson PM, Hedblad B, Rolandsson O, Franks PW, N?thlings 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.

Source: Am J Epidemiol. 2011 May 26. [Epub ahead of print]

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