April 16, 2026
View Full PaperWaist-to-Height Ratio Is Associated With the Risk of Coronary Artery Disease in Type 1 Diabetes: A 19-Year Cohort Study
Key Result
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).
Key Points
- This research aims to investigate the link between waist-to-height ratio and coronary artery disease risk in individuals with type 1 diabetes.
- Analyzed data from 4,349 individuals without prior coronary artery disease over 19 years.
- Defined central obesity based on a waist-to-height ratio of ≥0.5.
- Used Cox regression to assess associations with baseline covariates.
- Observed 664 CAD events (15.3%) during the follow-up period.
- 10-year cumulative CAD incidence was 11.6% for those with central obesity, compared to 4.4% without.
- The hazard ratio for CAD increased by 1.21 per 0.1-unit increase in WHtR overall, and 1.26 among those without albuminuria.
Study Design
Type
Cohort (n=4,349)
Structured PICO
Is central obesity (waist-to-height ratio ≥0.5) associated with an increased risk of coronary artery disease in individuals with type 1 diabetes?
P
Population
4,349 individuals with type 1 diabetes without prior coronary artery disease from the Finnish Diabetic Nephropathy Study
I
Intervention
Central obesity (defined as waist-to-height ratio [WHtR] ≥0.5)
C
Comparator
No central obesity (WHtR <0.5)
O
Outcome
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.
Main Result
Effect estimate: HR 1.21 (95% CI 1.06-1.38)
Absolute Event Rate: 25.3% vs 9.9%
p-value: p=0.006
Abstract
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.
Expert Takes1 quote
“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.”
Erika B. Parente, Researcher, Folkhälsän Research Center, HelsinkiFolkhälsän Research Centerauto_pipelineView source