The association between a body shape index and coronary heart disease in patients with diabetes: a cross-sectional study

A body shape index (ABSI) integrates waist circumference, height, and weight to better reflect central obesity. Diabetic patients have a high prevalence of coronary heart disease (CHD), and obesity-related metabolic disturbances are commonly observed in this population. However, the association between ABSI and CHD in individuals with diabetes has not been systematically investigated. A total of 6,192 adults with diabetes were enrolled in this study. Weighted multivariate logistic regression was used to assess the association between ABSI and the prevalence of CHD. Restricted cubic splines(RCS) were applied to examine the functional form of the association and assess potential nonlinearity. Subgroup analyses were conducted to evaluate heterogeneity by key population characteristics. ROC curves were used to compare the discriminative ability of ABSI against traditional anthropometric measures. Sensitivity analyses were conducted to assess the robustness of the findings. ABSI was significantly associated with higher odds of prevalent CHD (multivariable-adjusted OR = 1.26). Participants in the highest ABSI quartile (Q4) had the greatest odds of CHD compared with those in the lowest quartile (Q1), and all trend tests were statistically significant (P < 0.01). Restricted cubic spline analyses revealed a linear association between ABSI and prevalent CHD without evidence of a threshold effect. Subgroup analyses showed numerically higher point estimates in women, individuals aged ≥ 50 years, and those with heart failure; however, no interaction terms were statistically significant (P for interaction > 0.05). Receiver operating characteristic (ROC) analysis demonstrated that ABSI had modest discriminative ability for prevalent CHD (AUC = 0.63), which was higher than that of body mass index (AUC = 0.51), waist circumference (AUC = 0.55), and waist-to-height ratio (AUC = 0.53). Sensitivity analyses yielded results consistent with the main findings. These findings indicate that ABSI may be a relevant anthropometric correlate of prevalent CHD in adults with diabetes. Prospective longitudinal studies are warranted to further evaluate this association and assess its potential clinical relevance.