(25-07-11) Waist circumference and metabolic risk factors have separate and additive effects on 2 diabetes in patients with vascular diseases.

Waist circumference and metabolic risk factors have separate and additive effects on 2 diabetes in patients with vascular diseases.
A cohort the risk of future Type study.
Wassink AM, van der Graaf Y, van Haeften TW, Spiering W, Soedamah-Muthu SS, Visseren FL; on behalf of the SMART Study Group.
Source
Department of Vascular Medicine Julius Centre for Health Sciences and Primary Care Department of Endocrinology, University Medical Centre Utrecht Division of Human Nutrition, Wageningen Universiteit, Wageningen, the Netherlands.
Abstract
 Diabet. Med. 28, 932-940 (2011) ABSTRACT: Aims To assess the effect of various measures of adiposity and of metabolic risk 2 factors, both separately and in combination, on the risk of future Type This was a diabetes in patients with manifest vascular diseases. Methods years) with manifest 12 ?? prospective cohort study in 2924 patients (mean age 59 atherosclerosis. Metabolic risk factors were defined according to National Cholesterol Education Program criteria for the metabolic syndrome. Incidence of 2 diabetes was assessed by questionnaire and subsequent verification. Type years) there were years (range 3.0-7.6  During a median follow-up of 4.9 Results sd waist 2 diabetes. An increase with 1 178 cases (6.1%) of incident Type 2 diabetes in both circumference showed a strong association with incident Type CI CI 1.97-3.04) and women (hazard ratio 1.77, 95% men (hazard ratio 2.45, 95% 1.38-2.26). Compared with patients with normal (i.e. below the National Cholesterol Education Program criteria for abdominal adiposity) waist circumference and <3 metabolic risk factors, both patients with normal waist  3 metabolic risk factors and patients with high (i.e. above circumference and ?? the National Cholesterol Education Program criteria for abdominal adiposity) waist circumference and <3 metabolic risk factors had an increased risk of  CI 1.37-4.36 and hazard ratio 3.61, 2 diabetes (hazard ratio 2.44, 95% Type CI 2.23-5.85, respectively). Patients with both high waist circumference and 95% 2 diabetes 3 metabolic risk factors had the highest risk of developing Type ?? In patients with manifest CI 6.95-16.64). Conclusions (hazard ratio 10.76, 95% 3 metabolic risk factors and presence of a atherosclerosis, both presence of ?? high waist circumference alone are associated with increased risk for developing 3 metabolic risk factors and high 2 diabetes. The combined presence of ?? Type waist circumference, which is present in 15% of patients, is associated with a 2 diabetes. To identify patients with 10-fold increased risk of future Type 2 diabetes, fat manifest atherosclerosis at the highest risk of developing Type distribution in combination with metabolic risk factors should be considered.

Source: Diabet Med. 2011 Aug;28(8):932-940. doi: 10.1111/j.1464-5491.2011.03318.x.

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