A 0.1-unit increase in waist-to-height ratio was associated with a higher risk of coronary artery disease in type 1 diabetes (HR 1.21; 95% CI 1.06-1.38; P=0.006).
Cohort
Is central obesity (waist-to-height ratio ≥0.5) associated with an increased risk of coronary artery disease in individuals with type 1 diabetes?
4,349 individuals with type 1 diabetes without prior coronary artery disease from the Finnish Diabetic Nephropathy Study
Central obesity (defined as waist-to-height ratio [WHtR] ≥0.5)
No central obesity (WHtR <0.5)
Composite of acute myocardial infarction, coronary revascularizations, and CAD-related deathcomposite
Waist-to-height ratio is a significant predictor of coronary artery disease risk in patients with type 1 diabetes, particularly among those without albuminuria.
Obesity, kidney disease, and coronary artery disease (CAD) are interconnected. Here, the relationship between central obesity and CAD across albuminuria categories in type 1 diabetes was investigated. Data on 4,349 individuals without prior CAD from the Finnish Diabetic Nephropathy Study were analyzed. Central obesity was defined as waist-to-height ratio (WHtR) ≥0.5. Outcomes included acute myocardial infarction, coronary revascularizations, and CAD-related death. Associations were assessed with Cox regression adjusted for baseline covariates. Over a median 19-year follow-up, 664 CAD events (15.3%) occurred. The 10- and 20-year cumulative CAD incidences were 11.6% and 25.3%, respectively, in those with central obesity versus 4.4% and 9.9% without, respectively. In multivariable analysis, the hazard ratio for CAD per 0.1-unit WHtR increase was 1.21 (95% CI, 1.06–1.38); P = 0.006) overall and 1.26 (95% CI, 1.02–1.56; P = 0.03) among those without albuminuria. In conclusion, WHtR is associated with increased CAD risk in type 1 diabetes, particularly among those without albuminuria.
“As long as they have accumulation of fat in the center of body and they can develop this low-grade inflammation that also goes to insulin-load sensitivity, people with T1DM can accumulate fat in the liver as do people with T2DM and the general population.”
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Erika B. Parente
Fanny Jansson Sigfrids
Per-Henrik Groop
Diabetes Care
Monash University
University of Helsinki
Helsinki University Hospital
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Parente et al. (Tue,) conducted a cohort in Type 1 diabetes (n=4,349). Central obesity (waist-to-height ratio ≥0.5) vs. Without central obesity was evaluated on Acute myocardial infarction, coronary revascularizations, and CAD-related death (HR 1.21, 95% CI 1.06-1.38, p=0.006). A 0.1-unit increase in waist-to-height ratio was associated with a higher risk of coronary artery disease in type 1 diabetes (HR 1.21; 95% CI 1.06-1.38; P=0.006).
www.synapsesocial.com/papers/69e07d1d2f7e8953b7cbe1d0 — DOI: https://doi.org/10.2337/dc25-2811