K Rådholm1, A Tengblad2, E Dahlén2, T Länne3, J Engvall4, F H Nystrom3, C J Östgren2. 1. Division of Community Medicine, Primary Care, Department of Medicine and Health Sciences, Faculty of Medicine and Health Sciences, Linköping University, Department of Local Care West, County Council of Östergötland, SE-581 83 Linköping, Sweden. Electronic address: karin.radholm@liu.se. 2. Division of Community Medicine, Primary Care, Department of Medicine and Health Sciences, Faculty of Medicine and Health Sciences, Linköping University, Department of Local Care West, County Council of Östergötland, SE-581 83 Linköping, Sweden. 3. Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Faculty of Medicine and Health Sciences, Linköping University, SE-58185 Linköping, Sweden. 4. Department of Clinical Physiology, Faculty of Medicine and Health Sciences, Linköping University, Linköping, SE-58183, Sweden.
Abstract
BACKGROUND AND AIMS: Obesity is associated with diabetes type 2 and one of the most important risk factors for cardiovascular disease. We explored if sagittal abdominal diameter (SAD) is a better predictor of major cardiovascular events than waist circumference (WC) and body mass index (BMI) in type 2 diabetes. METHODS AND RESULTS: The CARDIPP study consists of a cohort of patients with type 2 diabetes. In this study we used data from 635 participants with no previous myocardial infarction or stroke, with a mean follow-up time of 7.1 years. SAD, WC and BMI were measured at baseline and the end-point was first cardiovascular event, measured as a composite of ICD-10 codes for acute myocardial infarction, stroke or cardiovascular mortality. SAD was significantly higher in the major cardiovascular event group compared to participants that did not suffer a major cardiovascular event during follow-up (p < 0.001). SAD >25 cm was the only anthropometric measurement that remained associated with major cardiovascular events when adjusted for modifiable and non-modifiable factors (hazard ratio 2.81, 95% confidence interval 1.37-5.76, p = 0.005). CONCLUSION: SAD with the cut off level of >25 cm, if confirmed in larger studies, may be used as a more independent risk-assessment tool compared with WC in clinical practice, to identify persons with type 2 diabetes at high cardiovascular risk. ClinicalTrials.gov: NCT01049737.
BACKGROUND AND AIMS: Obesity is associated with diabetes type 2 and one of the most important risk factors for cardiovascular disease. We explored if sagittal abdominal diameter (SAD) is a better predictor of major cardiovascular events than waist circumference (WC) and body mass index (BMI) in type 2 diabetes. METHODS AND RESULTS: The CARDIPP study consists of a cohort of patients with type 2 diabetes. In this study we used data from 635 participants with no previous myocardial infarction or stroke, with a mean follow-up time of 7.1 years. SAD, WC and BMI were measured at baseline and the end-point was first cardiovascular event, measured as a composite of ICD-10 codes for acute myocardial infarction, stroke or cardiovascular mortality. SAD was significantly higher in the major cardiovascular event group compared to participants that did not suffer a major cardiovascular event during follow-up (p < 0.001). SAD >25 cm was the only anthropometric measurement that remained associated with major cardiovascular events when adjusted for modifiable and non-modifiable factors (hazard ratio 2.81, 95% confidence interval 1.37-5.76, p = 0.005). CONCLUSION: SAD with the cut off level of >25 cm, if confirmed in larger studies, may be used as a more independent risk-assessment tool compared with WC in clinical practice, to identify persons with type 2 diabetes at high cardiovascular risk. ClinicalTrials.gov: NCT01049737.
Authors: Michael Sze Ka Wong; Matthias S Leisegang; Christoph Kruse; Juri Vogel; Christoph Schürmann; Nathalie Dehne; Andreas Weigert; Eva Herrmann; Bernhard Brüne; Ajay M Shah; Dieter Steinhilber; Stefan Offermanns; Geert Carmeliet; Klaus Badenhoop; Katrin Schröder; Ralf P Brandes Journal: Circulation Date: 2015-06-02 Impact factor: 29.690