Waist-Height Ratio and the Risk of Severe Diabetic Eye Disease in Type 1 Diabetes : A 15-Year Cohort Study

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Parente , E B , Harjutsalo , V , Forsblom , C & Groop , P-H 2022 , ' Waist-Height Ratio and the Risk of Severe Diabetic Eye Disease in Type 1 Diabetes : A 15-Year Cohort Study ' , Journal of Clinical Endocrinology and Metabolism , vol. 107 , no. 2 , pp. E653-E662 . https://doi.org/10.1210/clinem/dgab671

Title: Waist-Height Ratio and the Risk of Severe Diabetic Eye Disease in Type 1 Diabetes : A 15-Year Cohort Study
Author: Parente, Erika B.; Harjutsalo, Valma; Forsblom, Carol; Groop, Per-Henrik
Contributor organization: CAMM - Research Program for Clinical and Molecular Metabolism
Nefrologian yksikkö
Helsinki University Hospital Area
Research Programs Unit
HUS Abdominal Center
Department of Medicine
Per Henrik Groop / Principal Investigator
Clinicum
Date: 2022-02
Language: eng
Number of pages: 10
Belongs to series: Journal of Clinical Endocrinology and Metabolism
ISSN: 0021-972X
DOI: https://doi.org/10.1210/clinem/dgab671
URI: http://hdl.handle.net/10138/342239
Abstract: Context: Obesity prevalence has increased in type 1 diabetes (T1D). However, the relationship between body composition and severe diabetic eye disease (SDED) is unknown. Objective: To investigate the associations between body composition and SDED in adults with T1D. Methods: From 5401 adults with T1D in the Finnish Diabetic Nephropathy Study, we assessed 3468, and 437 underwent dual-energy X-ray absorptiometry for body composition analysis. The composite outcome was SDED, defined as proliferative retinopathy, laser treatment, antivascular endothelial growth factor treatment, diabetic maculopathy, vitreous hemorrhage, and vitrectomy. Logistic regression analysis evaluated the associations between body composition and SDED. Multivariable Cox regression analysis assessed the associations between the anthropometric measures and SDED. Subgroup analysis was performed by stages of albuminuria. The relevance ranking of each variable was based on the z statistic. Results: During a median follow-up of 14.5 (interquartile range 7.8-17.5) years, 886 SDED events occurred. Visceral/android fat ratio was associated with SDED [odds ratio (OR) 1.40, z = 3.13], as well as the percentages of visceral (OR 1.80, z = 2.45) and android fat (OR 1.28, z = 2.08) but not the total body fat percentage. Waist-height ratio (WHtR) showed the strongest association with the SDED risk [hazard ratio (HR) = 1.28, z= 3.73], followed by the waist (HR 1.01, z = 3.03), body mass index (HR 1.03, z = 2.33), and waist-hip ratio (HR 1.15, z= 2.22).The results were similar in normo- and microalbuminuria but not significant in macroalbuminuria. A WHtR >= 0.5 increased the SDED risk by 28% at the normo- and microalbuminuria stages. Conclusions: WHtR, a hallmark of central obesity, is associated with SDED in individuals with T1D.
Subject: retinopathy
type 1 diabetes
body composition
waist-height ratio
nephropathy
VISCERAL FAT ACCUMULATION
NECROSIS-FACTOR-ALPHA
RETINOPATHY
OBESITY
ADULTS
TOOL
3121 General medicine, internal medicine and other clinical medicine
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion


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