Waist-to-Height Ratio Predicts Heart Risk in Type 1 Diabetes, reveals research
A study published in Diabetes Care has revealed that a higher waist-to-height ratio (WHtR) is linked to an increased risk of Coronary Artery Disease in patients with Type 1 Diabetes, independent of traditional risk factors, making WHtR a simple tool for better cardiovascular risk assessment. The study was conducted by Erika B P and colleagues.
To explore these correlations, investigators studied a highly representative population of 4,349 subjects suffering from type 1 diabetes but with no prior record of CAD. All patients under investigation have been enrolled into the FinnDiane Study, a national study aimed at discovering risk factors contributing to diabetes complications. Central obesity has been rigorously assessed with the help of the waist-to-height ratio; a value of ≥0.5 has been applied as the cut-off point in classifying patients.
The incidence of major cardiovascular events, such as acute myocardial infarction, revascularizations, and mortality due to CAD, has been recorded throughout the study. Having followed all patients for a median period of 19 years, the investigators have managed to examine the development of heart disease at different stages of renal function impairment as characterized by albuminuria.
Key findings:
- The incidence of CAD was 664 events, accounting for 15.3% of all the study participants. Separating the population by whether they had central obesity, the incidence of CAD within 10 years was 11.6% among subjects with high WHtR compared to 4.4% in those without.
- The difference became more pronounced as time progressed since within 20 years, the incidence of CAD among those with central obesity was 25.3% as opposed to 9.9% among the lean group.
- Based on multivariable Cox regression model, each 0.1 unit rise in WHtR was associated with an HR of 1.21 (95% CI, 1.06-1.38; P = 0.006).
- Although albuminuria is already recognized as one of the earliest risk factors for kidney and heart problems, this study showed that central obesity was an even more aggressive risk factor in the low-risk population.
- Within those free from albuminuria, the HR of CAD with each 0.1 increase in WHtR was 1.26 (95% CI, 1.02-1.56; P = 0.03).
The 19-year follow-up in the FinnDiane Study population confirms that central obesity is a significant contributor to the development of coronary artery disease among patients with type 1 diabetes. This study has shown that a high waist-to-height ratio is associated with a 20-year cumulative incidence of CAD of 25.3%, which is a significant predictor of heart complications. What is most important about this finding is the fact that central obesity poses a greater risk for developing heart problems in patients who do not have any early signs of kidney impairment.
Reference:
Erika Bezerra Parente, Fanny Jansson Sigfrids, Per-Henrik Groop, Lena M. Thorn, Niina Sandholm, Valma Harjutsalo, FinnDiane Study Group*; Waist-to-Height Ratio Is Associated With the Risk of Coronary Artery Disease in Type 1 Diabetes: A 19-Year Cohort Study. Diabetes Care 2026; dc252811. https://doi.org/10.2337/dc25-2811
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