Use of the waist‐to‐height ratio to predict cardiovascular risk in patients with diabetes: <scp>R</scp>esults from the <scp>ADVANCE‐ON</scp> study

Rådholm, Karin; Chalmers, John; Ohkuma, Toshiaki; Peters, Sanne A.E.; Poulter, Neil; Hamet, Pavel; Harrap, Stephen; Woodward, Mark

doi:10.1111/dom.13311

Cited by 31 publications

(36 citation statements)

References 32 publications

(65 reference statements)

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“…WHR is the ratio of WC to hipline. A multinational study suggest that these indexes may have different values in predicting the risk of stroke, with a large proportion of them being Chinese (6). However, Jilin province is located in the northeast of China, and has a higher incidence of stroke (365/100,000 person-years) than other areas of China (326/100,000 person-years in Central China; 316/100,000 person-years in Northwest China; 275/100,000 person-years in North China; 232/100,000 person-years in East China; 154/100,000 person-years in South China; 153/100,000 person-years in Southwest China) (7).…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Four Anthropometric Indexes and Their Association With Stroke: A Population-Based Cross-Sectional Study in Jilin Province, China

et al. 2019

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Background: Stroke is a leading cause of long-term adult disability and death in China, and primary prevention is essential for stroke. The aim of this study is to compare the four anthropometric indexes (body mass index, waist circumference, waist-to-hip ratio, and waist-to-height ratio) and identify the index that is most closely related to stroke in areas with high incidence of stroke. Methods: A total of 4,052 participants aged 40 years or older were selected by the multistage stratified cluster sampling method in Dehui City in Jilin province, China. Face-to-face interviews and physical examinations were conducted to collect the participants' information. Descriptive data analyses were conducted. Multivariable logistic analyses were used to explore the adjusted association between stroke and body fat measuring indexes. Results: For body mass index (adjusted odds ratio (OR): 1.13, 95% confident interval (CI): 0.77-1.65), waist circumference (adjusted OR: 1.32, 95% CI: 0.88-1.99), and waist-to-hip ratio (adjusted OR: 1.34, 95% CI: 0.92-1.93), the patients in the highest quartile did not have a higher risk of stroke than those in the lowest quartile. For waist-to-height ratio, the patients in the highest quartile were more likely have a stroke than those in the lowest quartile (adjusted OR: 1.81, 95% CI: 1.16-2.82). The area under the curve of waist-to-height ratio, waist-to-hip ratio, waist circumference, and body mass index for stroke were 0.

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Section: Introductionmentioning

confidence: 99%

Comparison of the Four Anthropometric Indexes and Their Association With Stroke: A Population-Based Cross-Sectional Study in Jilin Province, China

et al. 2019

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“…The Akaike information criterion (AIC) measures goodness‐of‐fit, with smaller numbers suggesting better fit. Figure is as appears in Rådholm et al (2018)…”

Section: Epidemiological Investigationsmentioning

confidence: 66%

“…20,21 Waist-to-height was found to have a slight superiority compared to other anthropometric variables, with suggested thresholds for overweight and obesity of 0.55 and 0.6 ( Figure 5). 21 A practical advantage of this metric, compared with waist circumference as a measure of central obesity, is that these optimal thresholds appear to be consistent across sex and other key subgroups, at least amongst people with diabetes. Body mass index (BMI) was also found to be associated with the risk of a major renal event, that is, development of new macroalbuminuria, doubling of creatinine, end-stage renal disease or renal death; above a BMI of 25 kg/m 2 , there was an increasing risk with increasing BMI.…”

Section: Epidemiological Investigationsmentioning

confidence: 97%

“…Whether it is a risk factor for the sequelae of diabetes is less well established. Two ADVANCE papers have compared different measures of adiposity to the risk of CVD . Waist‐to‐height was found to have a slight superiority compared to other anthropometric variables, with suggested thresholds for overweight and obesity of 0.55 and 0.6 (Figure ) .…”

Section: Epidemiological Investigationsmentioning

confidence: 99%

“…Two ADVANCE papers have compared different measures of adiposity to the risk of CVD . Waist‐to‐height was found to have a slight superiority compared to other anthropometric variables, with suggested thresholds for overweight and obesity of 0.55 and 0.6 (Figure ) . A practical advantage of this metric, compared with waist circumference as a measure of central obesity, is that these optimal thresholds appear to be consistent across sex and other key subgroups, at least amongst people with diabetes.…”

Section: Epidemiological Investigationsmentioning

confidence: 99%

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Observational analyses from ADVANCE and ADVANCE‐ON

Chalmers

Woodward

2020

Diabetes Obesity Metabolism

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Aims To explain, and document, the epidemiological work associated with the action in diabetes and vascular disease: preterax and diamicron‐modified release controlled evaluation (ADVANCE) clinical trial. Materials and methods ADVANCE was designed as a randomized controlled multicentre factorial trial in high‐risk patients with diabetes. The two interventions were blood pressure lowering medications versus placebo, and intensive glucose control versus standard glucose control. Following termination of the trial, an observational study of surviving participants, able to join, was mounted: the ADVANCE ‐ observational study (ADVANCE‐ON). Other epidemiological analyses that were undertaken treated the trial as a cohort study, including using biomarkers from the blood samples taken from ADVANCE subjects as risk exposures. Results More than 50 publications have reported epidemiological results from ADVANCE. The main results from ADVANCE‐ON suggested attenuated benefits of ADVANCE's blood pressure lowering treatment on all‐cause and cardiovascular death, but no such long‐term benefits for intensive glucose control, although this did give persistent benefit for end‐stage renal disease. The other epidemiological studies found, amongst other things, strong effects of NT‐terminal pro‐B‐type natriuretic peptide and high‐sensitivity cardiac troponin T on macrovascular events, microvascular events and all‐cause death. Conclusions Embedding post‐randomization and epidemiological analyses into clinical trials is worthwhile and can be highly productive in advancing scientific knowledge.

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Fasting pancreatic polypeptide predicts incident microvascular and macrovascular complications of type 2 diabetes: An observational study

Sam,

Buckley,

Lam

et al. 2024

Diabetes Metabolism Res

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AimsPancreatic polypeptide (PP) is elevated in people with vascular risk factors such as type 2 diabetes or increased visceral fat. We investigated potential relationships between PP and microvascular and macrovascular complications of diabetes.Materials and MethodsAnimal study: Subcutaneous PP infusion for 4 weeks in high fat diet mouse model. Retinal mRNA submitted for Ingenuity Pathway Analysis. Human study: fasting PP measured in 1478 participants and vascular complications recorded over median 5.5 (IQR 4.9–5.8) years follow‐up.ResultsAnimal study: The retinal transcriptional response to PP was indicative of cellular stress and damage, and this footprint matched responses described in previously published studies of retinal disease. Of mechanistic importance the transcriptional landscape was consistent with upregulation of folliculin, a recently identified susceptibility gene for diabetic retinopathy. Human study: Adjusting for established risk factors, PP was associated with prevalent and incident clinically significant retinopathy (odds ratio (OR) 1.289 (1.107–1.501) p = 0.001; hazard ratio (HR) 1.259 (1.035–1.531) p = 0.0213), albuminuria (OR 1.277 (1.124–1.454), p = 0.0002; HR 1.608 (1.208–2.141) p = 0.0011), and macrovascular disease (OR 1.021 (1.006–1.037) p = 0.0068; HR 1.324 (1.089–1.61), p = 0.0049), in individuals with type 2 diabetes, and progression to diabetes in non‐diabetic individuals (HR 1.402 (1.081–1.818), p = 0.0109).ConclusionsElevated fasting PP is independently associated with vascular complications of diabetes and affects retinal pathways potentially influencing retinal neuronal survival. Our results suggest possible new roles for PP‐fold peptides in the pathophysiology of diabetes complications and vascular risk stratification.

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Use of the waist‐to‐height ratio to predict cardiovascular risk in patients with diabetes: Results from the ADVANCE‐ON study

Abstract: In patients with diabetes, WHtR is a useful indicator of future adverse risk, with similar effects in different population subgroups.

Cited by 31 publications

References 32 publications

Comparison of the Four Anthropometric Indexes and Their Association With Stroke: A Population-Based Cross-Sectional Study in Jilin Province, China

Comparison of the Four Anthropometric Indexes and Their Association With Stroke: A Population-Based Cross-Sectional Study in Jilin Province, China

Observational analyses from ADVANCE and ADVANCE‐ON

Fasting pancreatic polypeptide predicts incident microvascular and macrovascular complications of type 2 diabetes: An observational study

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