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. 2022 Apr 26:9:856517.
doi: 10.3389/fcvm.2022.856517. eCollection 2022.

Risk for Cardiovascular Death Associated With Waist Circumference and Diabetes: A 9-Year Prospective Study in the Wan Shou Lu Cohort

Man Li  1 , Ping Zhu  1 , Shu-Xia Wang  1
Affiliations

Risk for Cardiovascular Death Associated With Waist Circumference and Diabetes: A 9-Year Prospective Study in the Wan Shou Lu Cohort

Man Li et al. Front Cardiovasc Med. .

Abstract

Background: It has been reported that obesity and diabetes are both risk factors for the development of cardiovascular diseases (CVDs). However, recent articles reported that compared with body mass index, waist circumference (WC) can better reflect obesity, more closely related to visceral fat tissue which is positively associated with an increased risk of cardiovascular death. Moreover, few studies have investigated the prognostic value of both WC and diabetes during a long-term follow-up. We aimed to investigate whether the higher level of WC measurements and diabetes were able to predict cardiovascular mortality in the general population.

Methods: In this prospective cohort study, a total of 1,521 consecutive subjects free of clinical CVD were included. The endpoint was cardiovascular death. The Kaplan-Meier method and Cox regression models were used to evaluate the cumulative risk of the outcome at different WC levels with or without diabetes.

Results: During a median follow-up of 9.2 years, 265 patients died due to cardiovascular conditions. Kaplan-Meier survival estimates indicated that the patients with higher levels of WC (WC > 94 cm) coexisted with diabetes had a significantly increased risk of cardiovascular death (log-rank p < 0.05). After adjustment for potential confounders, multiple COX regression models showed that the incidence of cardiovascular death was significantly higher when patients with high WC coexisted with diabetes mellitus (hazard ratio: 3.78; 95% CI: 3.35-3.98; p < 0.001).

Conclusion: Patients with high WC and diabetes represent a high-risk population for cardiovascular death. WC and diabetes may provide incremental prognostic value beyond traditional risks factors.

Keywords: cardiovascular death; cardiovascular-outcome; diabetes; obesity; waist circumference.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The flowchart of the study.
Figure 2
Figure 2
Kaplan–Meier curves in different subgroups. (A) Kaplan–Meier survival rate of the participants according to the different WC levels. (B) Kaplan–Meier survival rate of the participants with or without DM. (C) Kaplan–Meier survival rate of the participants with DM and non-DM according to different degrees of WC.
Figure 3
Figure 3
Cox-adjusted event-free survival curves for freedom of cardiovascular death in the different subgroups after adjustment for potential clinical confounders. (A) Cox-adjusted event-free survival curves of the participants according to the different WC levels. (B) Cox-adjusted event-free survival curves of the participants with or without DM. (C) Cox-adjusted event-free survival curves of the participants with DM and non-DM according to different degree of WC.
Figure 4
Figure 4
(A) Associations of clinical confounders and the prevalence of cardiovascular death. (B) Associations of different degrees of WC and DM and the prevalence of cardiovascular death in different subgroups.
See this image and copyright information in PMC

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