TY - JOUR
T1 - Comparison of waist-to-hip ratio and other obesity indices as predictors of cardiovascular disease risk in people with type-2 diabetes: A prospective cohort study from ADVANCE
AU - Czernichow, Sebastien
AU - Kengne, Andre-Pascal
AU - Huxley, Rachel
AU - Batty, George
AU - De Galan, Bastiaan E
AU - Grobbee, Diederick
AU - Pillai, Avinesh
AU - Zoungas, Sophia
AU - Marre, Michel
AU - Woodward, Mark
AU - Neal, Bruce
AU - Chalmers, John
PY - 2011
Y1 - 2011
N2 - AIMS: The aim of this study was to compare the strength of associations and discrimination capability of body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) with cardiovascular disease risk in individuals with type-2 diabetes.
METHODS AND RESULTS: Eleven thousand, one hundred and forty men and women were followed for a mean of 4.8 years. The Cox proportional hazard models were used to compute the hazard ratios and 95 confidence intervals (95 CI) for one standard deviation (SD) increase in baseline BMI (SD: 5 kg/m), WC (SD: 13 cm) and WHR (SD: 0.08) with cardiovascular disease risk. After adjustment, hazard ratio (95 CI) for WC were 1.10 (1.03-1.18) for cardiovascular events, 1.13 (1.03-1.24) for coronary events, and 1.08 (0.98-1.19) for cardiovascular deaths. Estimates for WHR were 1.12 (1.05-1.19), 1.17 (1.08-1.28) and 1.19 (1.09-1.31). BMI was not related to any of these outcomes. Although the receiver operating characteristic curve could not differentiate between anthropometric variables (P values >/=0.24), the relative integrated discrimination improvement statistic showed an enhancement in the discrimination capabilities of models using WHR for cardiovascular outcomes, except for cerebrovascular events.
CONCLUSION: Strengths of associations and discrimination statistics suggested that WHR was the best predictor of cardiovascular events and mortality in patients with type-2 diabetes and BMI the worst.
AB - AIMS: The aim of this study was to compare the strength of associations and discrimination capability of body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) with cardiovascular disease risk in individuals with type-2 diabetes.
METHODS AND RESULTS: Eleven thousand, one hundred and forty men and women were followed for a mean of 4.8 years. The Cox proportional hazard models were used to compute the hazard ratios and 95 confidence intervals (95 CI) for one standard deviation (SD) increase in baseline BMI (SD: 5 kg/m), WC (SD: 13 cm) and WHR (SD: 0.08) with cardiovascular disease risk. After adjustment, hazard ratio (95 CI) for WC were 1.10 (1.03-1.18) for cardiovascular events, 1.13 (1.03-1.24) for coronary events, and 1.08 (0.98-1.19) for cardiovascular deaths. Estimates for WHR were 1.12 (1.05-1.19), 1.17 (1.08-1.28) and 1.19 (1.09-1.31). BMI was not related to any of these outcomes. Although the receiver operating characteristic curve could not differentiate between anthropometric variables (P values >/=0.24), the relative integrated discrimination improvement statistic showed an enhancement in the discrimination capabilities of models using WHR for cardiovascular outcomes, except for cerebrovascular events.
CONCLUSION: Strengths of associations and discrimination statistics suggested that WHR was the best predictor of cardiovascular events and mortality in patients with type-2 diabetes and BMI the worst.
UR - http://www.ncbi.nlm.nih.gov/pubmed/20628304
U2 - 10.1097/HJR.0b013e32833c1aa3
DO - 10.1097/HJR.0b013e32833c1aa3
M3 - Article
SN - 1741-8267
VL - 18
SP - 312
EP - 319
JO - European Journal of Cardiovascular Prevention & Rehabilitation
JF - European Journal of Cardiovascular Prevention & Rehabilitation
ER -
