Impact of diabesity phenotype on cardiovascular diseases, major cardiovascular events and all-cause mortality

Abstract

To investigate the longitudinal association of different phenotypes of diabetes and obesity with the incidence of cardiovascular disease (CVD), CVD- and all-cause mortality. A total of 5432 adults, aged ≥ 35 years and free of CVD were included in this cohort study. Diabesity phenotypes were defined in six categories based on the presence of diabetes (normal (NG), prediabetes and diabetes) and obesity (obese, non-obese). Fasting blood sugar, 2-h post prandial glucose, or using anti-diabetic medicines were used to define diabetes, and body mass index and waist circumference were used to define obesity. Cox proportional hazards models were used to estimate hazard ratios (HRs) for incident CVD, CVD- and all-cause mortality across these categories. After a median follow-up of 11.25 years, 819 CVD cases, 181 CVD deaths and 488 all-cause deaths occurred. In multivariable-adjusted models and irrespective of obesity definition, the phenotypes of normal glucose-obese, prediabetes-obese and pre-diabetes-non obese were not associated with CVD incidence in comparison with NG-non obese phenotype, however, the phenotypes of diabesity, either defined by general or abdominal obesity, were associated with increased risk of incident CVD events (HR = 1.42, 95% CI 1.01, 1.99, and HR = 1.46, 95% CI 1.07, 1.98, respectively). These findings were sex-specific and only in men with a phenotype of abdominal obesity-diabetes, a positive link was observed for CVD incidence (HR = 1.60, 95% CI 1.01, 2.52). No significant association was found between diabesity and death from CVD or all causes. Diabesity is a predictor of CVD and stroke incidence, but not CVD or all-cause mortality, among Iranians. This association is more pronounced amongst men than women.

Associations of diabesity with all‐cause and cardiovascular disease mortality: Findings from the Mexico City Prospective Study

“…Over 11.25 years of follow-up of 5432 Iranians, diabesity (defined either using BMI or waist circumference) was associated with a higher incident CVD risk but not with CVD or all-cause mortality. 16 In Mexico, only one previous study in older adults explored this combination but focused mainly on cognitive impairment and mortality alone. 7 Using data from 7885 participants from the Mexican Health and Aging Study, Milani et al 7 identified that diabesity was associated with a 1.70 higher risk of cognitive impairment relative risk: 1.70 (95% CI: 1.168-2.48) while for mortality, only diabetes was associated with a higher mortality risk.…”

“…Nonetheless, very few prospective studies have explored their joint association with the occurrence of CVD and all‐cause mortality over a long study period and in a large database. Over 11.25 years of follow‐up of 5432 Iranians, diabesity (defined either using BMI or waist circumference) was associated with a higher incident CVD risk but not with CVD or all‐cause mortality 16 . In Mexico, only one previous study in older adults explored this combination but focused mainly on cognitive impairment and mortality alone 7 .…”

“…11 Furthermore, based on the same national data, the prevalence of diabetes was 18.3%. 12 Even if the individual association of obesity and diabetes with mortality has been widely investigated worldwide, [13][14][15] very few investigations have been conducted on the association of diabesity with adverse outcomes, 16 and, to the best of our knowledge, no large cohort studies have explored this association both in middle-aged and older adults in the Latin America Region. Therefore, considering that obesity and diabetes are known to be individually associated with mortality, this study aimed to investigate the joint associations of diabesity with all-cause and CVD mortality in the Mexico City Prospective Study.…”

Independent relationship between sleep apnea-specific hypoxic burden and glucolipid metabolism disorder: a cross-sectional study

“…Previous studies have confirmed that SASHB is one of the important early warning indicators of risk for cardiovascular morbidity and mortality, and given that abnormalities in glucose and lipid metabolism are established risk factors for cardiovascular morbidity and mortality [ 31 ], there has been an ongoing effort to find potential factors associated with glucose and lipid homeostasis. The impact of SASHB, an important early warning indicator for assessing IH in patients with OSA, on glucose metabolism and lipid metabolism remains unknown.…”