Abstract 12258: Measurement of Waist Circumference Predicts Coronary Atherosclerosis Above Plasma Adipokines in Type 2 Diabetes
Objectives: Waist Circumference (WC) independently predicts atherosclerosis and cardiovascular events beyond known cardiovascular (CV) risk factors in type 2 diabetes (T2D). We have shown that plasma leptin and adiponectin levels are associated with CAC differentially across T2D status. However, the relationship between WC, plasma adiponectin and plasma leptin levels in CAC prediction beyond CV risk factors is unknown.
Methods: We performed cross sectional analyses in two community based multiracial studies: the Penn Diabetes Heart study (N= 1106, T2DM subjects, 65% men) and combination of the Study of Inherited Risk of Coronary Atherosclerosis & Philadelphia Area MetSyn Network (N= 1549, non-T2D subjects, 59.97 % men). Using STATA 10 (College Station, TX), we performed multivariate analysis of CV risk factors and WC, plasma adiponectin and plasma leptin in predicting CAC. Nested models were completed to test incremental value of each marker beyond other CV risk factors.
Results: There was significant subclinical disease in both T2D (CAC Agatston: mean 310, median 44) and non-T2D (mean 110, median 2) groups. In Tobit multivariable models adjusted for age, gender, race, tobacco, hypertension, hypercholesterolemia, cardiac medications, family history, exercise and highly sensitive C-reactive protein, WC predicted CAC in both T2D [Tobit regression ratio of increased CAC: 1.33 (p=0.021)] and non-T2D [1.85 (p<0.001)] group. Plasma leptin was found to be a significant independent predictor of CAC in fully adjusted model in both T2D [1.61 (p=0.009)] and non-T2D [1.53 (p=0.003)], but not adiponectin. In nested models, leptin (chi2 2.39, p=0.12) nor adiponectin (chi2 2.43p=0.11) did not add to WC in CAC prediction beyond known CV risk factors across T2D status.
Conclusions: In the face of important biomarkers of adiposity such as plasma adiponectin and leptin, WC remained the most significant predictor of CAC in T2D. This underscores the importance of WC measurement in routine practice in caring for T2D as the CVD risk remains high despite aggressive guidelines.
- © 2010 by American Heart Association, Inc.