Prediction of Cardiovascular Events with Consideration of General and Central Obesity Measures in Diabetic Adults: Results of the 8.4-Year Follow-Up

Background: Obesity is one of the most important cardiovascular disease (CVD) risk factors among diabetic populations. We evaluated the ability of different anthropometric measures for predicting CVD among type 2 diabetic patients. Methods: The study consisted of 411 men and 599 women, aged >= 30 years, free of CVD at baseline with a median follow-up of 8.4 years. The adjusted hazard ratios (HRs) for CVD were calculated for a 1 standard deviation change in body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) using Cox proportional regression analysis. Results: A total of 188 CVD events occurred (men, 90; women, 98). In women, in confounder-adjusted analysis [age, fasting plasma glucose (instead of glycosylated hemoglobin), and positive family history of CVD], WHR was associated with incident CVD [1.32 (1.06-1.65)], followed by WC and WHtR, which were marginally significant (P = 0.06 and 0.08, respectively); after adjustment for hypertension and hypercholesterolemia, only WHR predicted CVD significantly. In men, the confounder-adjusted (age, fasting plasma glucose, and aspirin use) HR to predict CVD was significant only for WHR [HR 1.21(1.00-1.48)]. Conclusion: This study showed WHR was the most powerful predictor of CVD among anthropometric measures, followed by WHtR, in diabetic population.