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Am J Epidemiol. 2011 Jul 1;174(1):22-34. doi: 10.1093/aje/kwr048. Epub 2011 May 26.

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

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1
Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrucke, Arthur-Scheunert-Allee 114–116, 14558 Nuthetal, Germany. diewertje.sluik@dife.de

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.

PMID:
21616928
DOI:
10.1093/aje/kwr048
[Indexed for MEDLINE]

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