Key result
Higher waist-to-hip ratio, unlike BMI, linked to ~11% greater MACE-3 risk per SD in T2D.
Why the study?
Anthropometric measures other than BMI are rarely assessed in clinical practice yet may be more predictive of cardiovascular risk in participants with type 2 diabetes.
Do central adiposity measures (waist-to-hip ratio, waist circumference) predict cardiovascular outcomes better than BMI in high-risk patients with type 2 diabetes?
Population
Participants with type 2 diabetes in the REWIND placebo group
Comparison
BMI vs WHR vs WC as risk factors for CVD-related outcomes
Design
Post hoc analysis of a randomized trial placebo group
Follow-up
Median of 5.4 years
Authors
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May refine MACE risk stratification beyond BMI in high-risk T2D; hypothesis-generating and requires prospective validation.
Cohort (n=4,952)
Yes
Do central adiposity measures (waist-to-hip ratio, waist circumference) predict cardiovascular outcomes better than BMI in high-risk patients with type 2 diabetes?
Hazard Ratio: 1.11 (95% CI 1.03–1.21)
p-value: p=0.009
Central adiposity measures (waist-to-hip ratio and waist circumference) are better predictors of MACE-3 and mortality than BMI in patients with type 2 diabetes, whereas BMI is a stronger predictor for heart failure hospitalization.
Franek et al. (2023) conducted a cohort in Type 2 diabetes with high cardiovascular risk (n=4,952). Waist-to-hip ratio (per 1 SD increase) vs. Lower waist-to-hip ratio was evaluated on MACE-3 (HR 1.11, 95% CI 1.03-1.21, p=0.009). In patients with type 2 diabetes and high cardiovascular risk, a one standard deviation increase in waist-to-hip ratio was associated with an increased risk of MACE-3 (HR 1.11), whereas BMI was not.
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