Waist-to-height ratio has a stronger association with cardiovascular risks than waist circumference, waist-hip ratio and body mass index in type 2 diabetes

Ke, Jiang-Feng; Wang, Junwei; Lu, Junxi; Zhang, Zhihui; Liu, Yun; Li, Lianxi

doi:10.1016/j.diabres.2021.109151

Cited by 32 publications

(47 citation statements)

References 44 publications

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“…Horvei et al 32 reported that WHtR and WHR have the highest association with the risk of myocardial infarction among various anthropometric indices. Our finding was consistent with the results of previous studies, indicating that WC or WHtR was highly associated with MIAP in adult men 3 , 11 , 32 . However, our results did not indicate an association between obesity indices and myocardial infarction in women, as has been mentioned in previous studies 5 .…”

Section: Discussionsupporting

confidence: 93%

“…Pandey et al 4 examined the association between components of metabolic syndrome and acute myocardial infarction in Nepal and argued that WC was associated with the disease. Ke et al 11 analyzed the association of a history of myocardial infarction, angina pectoris, ischemic or hemorrhagic stroke, and transient ischemic attack with four obesity indices in Chinese patients with type 2 diabetes. They argued that WHtR had a higher association with the studied diseases than WC, WHR, and BMI.…”

Section: Discussionmentioning

confidence: 99%

“…The known risk factors for MIAP are very diverse and are as follows: waist circumference (WC) 3 , 4 , waist-to-hip ratio (WHR) 5 – 8 , body mass index (BMI) 9 , 10 , waist-to-height ratio (WHtR) 11 , serum cholesterol and triglyceride levels, smoking, hypertension 4 , 12 , fasting blood glucose level, high-density lipoprotein cholesterol (HDL-C) level, blood pressure 4 , family history of acute myocardial infarction 13 , thickness of the carotid-artery intima media 14 , mean platelet volume 15 , abnormal glucose tolerance 16 , race and ethnicity 17 . For example, increased thickness of the carotid-artery intima media increases the risk of myocardial infarction and stroke 14 .…”

Section: Introductionmentioning

confidence: 99%

“…Until now, although many studies have examined associations of biochemical and obesity indices with MIAP, the best index for MIAP risk assessment among various obesity indices remains controversial. One controversial issue was that many studies have indicated that the most important indices for myocardial infarction risk assessment are WHtR 11 , WHR 5 – 7 , WC 3 , 4 , 6 , and BMI 9 , 10 according to various major ethnic groups 7 . The other issue was that the association between various biochemical indices and acute myocardial infarction is unclear 19 because several studies reported that triglyceride levels were associated with MIAP 4 , whereas some studies indicated that triglyceride levels were not associated with the diseases 19 , 20 .…”

Section: Introductionmentioning

confidence: 99%

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Association of myocardial infarction and angina pectoris with obesity and biochemical indices in the South Korean population

Hee

Lee

2022

Sci Rep

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The best obesity index for myocardial infarction or angina pectoris (MIAP) risk assessment remains controversial. Furthermore, the association between biochemical indices and these diseases is unclear. This study examined associations of obesity and biochemical indices with MIAP in the Korean population. This large-scale cross-sectional study was based on the Korea National Health and Nutrition Survey dataset from 2010 to 2019. A total of 22,509 subjects (9452 men and 13,057 women) aged ≥ 50 years were included. Participants consisted of 21,426 individuals without MIAP (men = 8869, women = 12,557) and 1083 with MIAP (men = 583, women = 500). Binary logistic regression was performed to examine the association of MIAP with obesity and biochemical indices. The prevalence of MIAP in Korean adults aged ≥ 50 years was 4.81% (6.57% among men, 3.98% among women). MIAP was more strongly associated with total cholesterol than other variables in men (adjusted OR = 0.436 [0.384–0.495], adjusted p < 0.001) and women (adjusted OR = 0.541 [0.475–0.618], adjusted p < 0.001). The waist-to-height ratio (adjusted OR = 1.325 [1.082–1.623], adjusted p = 0.007) and waist circumference (adjusted OR = 1.290 [1.072–1.553], adjusted p = 0.007) showed a significant association with MIAP in men, with no association between obesity indices and MIAP in women after adjustment. The association between biochemical indices and MIAP differed slightly according to sex. Only total cholesterol, creatinine, and platelets were associated with MIAP in both men and women.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association of myocardial infarction and angina pectoris with obesity and biochemical indices in the South Korean population

Hee

Lee

2022

Sci Rep

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“…This cross-sectional, real-world study included T2DM patients hospitalized in the Department of Endocrinology and Metabolism, the Sixth People’s Hospital of Shanghai Jiao Tong University from January 2006 to December 2012, and some of the patient data were from our recent studies ( 11 , 24 – 26 ). The hospital ethical review committee approved this study [approved number: 2018-KY-018(K)], with written consent obtained from all participants.…”

Section: Methodsmentioning

confidence: 99%

Serum iron is closely associated with metabolic dysfunction-associated fatty liver disease in type 2 diabetes: A real-world study

Wang

Jin

et al. 2022

Front. Endocrinol.

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AimsThere is still a debate about the relationship between serum iron and metabolic dysfunction-associated fatty liver disease (MAFLD). Furthermore, few relevant studies were conducted in type 2 diabetes mellitus (T2DM). Therefore, this study aimed to explore the association of serum iron levels with MAFLD in Chinese patients with T2DM.MethodsThis cross-sectional, real-world study consisted of 1,467 Chinese T2DM patients. MAFLD was diagnosed by abdominal ultrasonography. Based on serum iron quartiles, the patients were classified into four groups. Clinical characteristics were compared among the four groups, and binary logistic analyses were used to assess the associations of serum iron levels and quartiles with the presence of MAFLD in T2DM.ResultsAfter adjusting for gender, age, and diabetes duration, significantly higher prevalence of MAFLD was found in the second (45.7%), third (45.2%), and fourth (47.0%) serum iron quartiles than in the first quartiles (26.8%), with the highest MAFLD prevalence in the fourth quartile (p < 0.001 for trend). Moreover, increased HOMA2-IR (p = 0.003 for trend) and decreased HOMA2-S (p = 0.003 for trend) were observed across the serum iron quartiles. Fully adjusted binary logistic regression analyses indicated that both increased serum iron levels (OR: 1.725, 95% CI: 1.427 to 2.085, p < 0.001) and quartiles (p < 0.001 for trend) were still closely associated with the presence of MAFLD in T2DM patients even after controlling for multiple confounding factors.ConclusionsThere is a positive correlation between the presence of MAFLD and serum iron levels in T2DM patients, which may be attributed to the close association between serum iron and insulin resistance. Serum iron levels may act as one of the indicators for evaluating the risk of MAFLD in T2DM individuals.

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High‐normal unconjugated bilirubin is associated with decreased risk of chronic kidney disease in type 2 diabetes: A real‐world study

Jin

et al. 2023

Diabetes Metabolism Res

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ObjectiveTo investigate the association between serum unconjugated bilirubin (UCB) within normal limits and chronic kidney disease (CKD) in T2DM patients.MethodThis cross‐sectional, real‐world study was performed in 8661 hospitalised T2DM patients. The subjects were stratified into quintiles based on serum UCB levels. The clinical characteristics and CKD prevalence were compared among the UCB quantile groups. The associations of serum UCB levels and quintiles with CKD were also analysed by binary logistic regression.ResultsAfter controlling for age, sex, and diabetes duration (DD), the CKD prevalence (20.4%, 12.2%, 10.6%, 8.3%, and 6.4% for the first, second, third, fourth, and fifth quintiles, respectively, p < 0.001 for trend) was significantly decreased across the serum UCB quintiles. The fully adjusted regression model showed negative associations of serum UCB levels (OR: 0.660, 95% CI: 0.585–0.744; p < 0.001 for trend) and quintiles (p < 0.001) with the presence of CKD. Compared with the subjects in the lowest UCB quintile, the risk of CKD decreased by 36.2%, 54.3%, 53.8%, and 62.1%, respectively, in those from the second to the highest UCB quintile. Additionally, C‐reactive protein (CRP) levels were significantly higher in the subjects with CKD than in those without CKD (p < 0.001), and significantly decreased across the UCB quintiles (p < 0.001 for trend).ConclusionsSerum UCB levels within the normal range were significantly and negatively linked to CKD in T2DM patients. High‐normal UCB may be an independent protective factor for CKD by its antioxidant and the following anti‐inflammatory activities through its signalling activity, which was indicated by clearly decreased CRP levels across the UCB quintiles.

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Waist-to-height ratio has a stronger association with cardiovascular risks than waist circumference, waist-hip ratio and body mass index in type 2 diabetes

Cited by 32 publications

References 44 publications

Association of myocardial infarction and angina pectoris with obesity and biochemical indices in the South Korean population

Association of myocardial infarction and angina pectoris with obesity and biochemical indices in the South Korean population

Serum iron is closely associated with metabolic dysfunction-associated fatty liver disease in type 2 diabetes: A real-world study

High‐normal unconjugated bilirubin is associated with decreased risk of chronic kidney disease in type 2 diabetes: A real‐world study

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