Rui Zhou1, Furong Li1, Guochong Chen2, Qiang Fu3, Shanyuan Gu4, Xianbo Wu1. 1. Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, Guangdong, China. 2. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA. 3. Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, St. Louis, Missouri, USA. 4. Baiyun Jinkang Hospital, Guangzhou, Guangdong, China.
Abstract
BACKGROUND: Previous epidemiological evidence on the sex-specific association of obesity, particularly abdominal obesity, as reflected by larger waist circumference (WC), with incident diabetic neuropathy (DN) remains limited. METHODS: We used data from a patient cohort with a median 10-year history of type 2 diabetes mellitus at the time of recruitment. A composite outcome of four types of predefined DN (Neuro 1-4) was used as the outcome of interest. Because of sex differences in abdominal obesity, analyses were conducted separately for men and women. RESULTS: Among the 7442 participants (4551 men and 2891 women) recruited in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study, 3999 cases of incident DN were documented (1413 in men and 853 in women). Larger WCs were associated with a higher risk of DN among both men and women. Compared with the lowest quintile, the HR for the highest quintile was 1.30 (95% CI 1.13-1.49) among men (P-trend <0.001). For women, the HR for the lowest vs highest quintile was 1.25 (95% CI 1.04-1.51) (P-trend <0.001). A linear relationship between WC and DN was observed in men, and in women, the risk of DN increased as the WC quintile increased before it appeared to plateau. The relationship between BMI and incident DN was similar to the results observed for WC. CONCLUSION: General and abdominal obesity were both associated with an increased risk of incident DN among individuals with type 2 diabetes mellitus, regardless of sex. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
BACKGROUND: Previous epidemiological evidence on the sex-specific association of obesity, particularly abdominal obesity, as reflected by larger waist circumference (WC), with incident diabetic neuropathy (DN) remains limited. METHODS: We used data from a patient cohort with a median 10-year history of type 2 diabetes mellitus at the time of recruitment. A composite outcome of four types of predefined DN (Neuro 1-4) was used as the outcome of interest. Because of sex differences in abdominal obesity, analyses were conducted separately for men and women. RESULTS: Among the 7442 participants (4551 men and 2891 women) recruited in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study, 3999 cases of incident DN were documented (1413 in men and 853 in women). Larger WCs were associated with a higher risk of DN among both men and women. Compared with the lowest quintile, the HR for the highest quintile was 1.30 (95% CI 1.13-1.49) among men (P-trend <0.001). For women, the HR for the lowest vs highest quintile was 1.25 (95% CI 1.04-1.51) (P-trend <0.001). A linear relationship between WC and DN was observed in men, and in women, the risk of DN increased as the WC quintile increased before it appeared to plateau. The relationship between BMI and incident DN was similar to the results observed for WC. CONCLUSION: General and abdominal obesity were both associated with an increased risk of incident DN among individuals with type 2 diabetes mellitus, regardless of sex. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.