Incidence of CV events among diabetes patients substantially correlated with abdominal obesity indicators

CHINA: The incidence of cardiovascular events among individuals with type 2 diabetes was substantially correlated with all abdominal obesity indicators, according to a study published in Cardiovascular Diabetology.

Additionally, Chinese visceral adiposity index (CVAI) had the greatest performance for predicting incident CV events among various abdominal obesity measures.

The longitudinal relationship between waist circumference (WC), visceral adiposity index (VAI), lipid accumulation product (LAP), and Chinese visceral adiposity index (CVAI) and cardiovascular (CV) events in individuals with type 2 diabetes (T2D) is yet unknown.

"China has the biggest proportion of obese people in the world, with over 15% of adults suffering from overall obesity and over 35% from abdominal obesity between 2014 and 2018. Increasingly more data suggested that abdominal fat accumulation had a stronger correlation with the risk of diabetes and CVD than did overall obesity," Jianghong Dai and colleagues from the Department of Epidemiology and Biostatistics, School of Public Health, Xinjiang Medical University, China, stated

This study sought to analyze the predictive accuracy of several abdominal obesity indicators for risk assessment and to investigate the relationships between incident CV events and patients with T2D.

The Xinjiang Multi-Ethnic Cohort provided 2328, T2D patients for the current investigation. 59 months into the participants' follow-up, on average, 289 of them had encountered CV incidents. Analyses of multivariable Cox regression were used to evaluate the relationships between the indices of abdominal obesity and CV events. The predictive capability of each abdominal obesity indicator was assessed using Harrell's concordance statistic (C-statistic), the net reclassification improvement (NRI) index, and the integrated discrimination improvement (IDI) index.

Key findings of the study:

• Each 1-SD increase in WC, VAI, LAP, and CVAI was linked to a greater risk of CV events in individuals with T2D after multivariable adjustment; the adjusted hazard ratios (HRs) were 1.57 (95% CI: 1.39-1.78), 1.11 (95% CI: 1.06-1.16), 1.46 (95% CI: 1.36-1.57), and 1.78 (95% CI: 1.57-2.01) respectively.
• In subgroup analyses, those with a BMI of less than 25 kg/m2 showed higher beneficial relationships than people who were overweight or obese. When compared to VAI, LAP, WC, and BMI (C-statistic: 0.535 to 0.670, all P for comparison <0.05), CVAI showed the highest C-statistic (0.700, 95% CI 0.672-0.728) for predictive performance.
• The CVAI index likewise displayed the highest incremental risk when the abdominal obesity index was included to the basic risk model.

"In the context of public health, we might take into account lowering abdominal fat deposition in T2D patients as an intervention strategy for reducing CV events, especially in people with normal weight."

Large-scale randomized clinical trials are required, the investigators concluded, to support the idea.

REFERENCE

Qiao, T., Luo, T., Pei, H. et al. Association between abdominal obesity indices and risk of cardiovascular events in Chinese populations with type 2 diabetes: a prospective cohort study. Cardiovasc Diabetol 21, 225 (2022). https://doi.org/10.1186/s12933-022-01670-x