Abstract P443: The Importance of Waist Circumference and Body Mass Index for Mortality Risk in Diabetic Adults
Introduction: The number of individuals living with diabetes in the United States continues to increase, and these patients are at an increased risk of cardiovascular complications and premature mortality. The identification of risk factors for mortality in this population is a research priority.
Hypothesis: We tested the hypothesis that body mass index (BMI) and waist circumference are significantly related to all-cause mortality rates among diabetics.
Methods: The sample included 1,802 white (n = 1,130) and African American (n = 672) diabetic participants 18 to 88 years of age from the Pennington Center Longitudinal Study. Diabetic status was determined by a combination of self-reported physician diagnosis, fasting blood glucose, and diabetic medications. Height, weight, and waist circumference were measured using standard procedures during a clinic visit, and the BMI (kg/m2) was calculated. Self-reported smoking status, alcohol consumption and leisure-time physical activity levels were obtained using a questionnaire. Baseline assessments occurred between 1994 and 2009, and the vital status of the participants was determined from linkage with the National Death Index through 2009. Cox proportional hazards regression was used to assess the associations of BMI and waist circumference with all-cause mortality in separate models, adjusting for age, sex, race, year of baseline examination, smoking status, alcohol consumption and leisure-time physical activity. Hazard ratios (HR) are expressed per standard deviation of each independent variable.
Results: A total of 123 deaths occurred during 6.2 years of follow-up (11,174 person-years). In multivariable-adjusted models, both BMI (HR 1.25; 95% CI: 1.04 [[Unable to Display Character: –]] 1.51) and waist circumference (HR 1.39; 95%CI: 1.15 [[Unable to Display Character: –]] 1.68) demonstrated significant relationships with mortality. Higher death rates were observed in men (HR 1.95; 95% CI: 1.34 [[Unable to Display Character: –]] 2.84) and African Americans (HR 1.59; 95% CI: 1.08 [[Unable to Display Character: –]] 2.34) compared to women and whites, respectively. However, no significant race-by-BMI, race-by-waist circumference, sex-by-BMI, or sex-by-waist circumference interactions were observed.
Conclusions: The results indicate that maintaining a healthy BMI and waist circumference are important considerations for individuals living with diabetes.
- © 2013 by American Heart Association, Inc.