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Sex- and age-specific differences in associations of a body shape index with all-cause and cardiovascular death risks among US adults with diabetes

  • Author Footnotes
    1 Xueli Sun and Ling Gao contributed to this work equally.
    Xueli Sun
    Footnotes
    1 Xueli Sun and Ling Gao contributed to this work equally.
    Affiliations
    Center of Health Management, Clinical Medical College, Yangzhou University, 98 Nantong West Road, Yangzhou 225001, China
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  • Author Footnotes
    1 Xueli Sun and Ling Gao contributed to this work equally.
    Ling Cao
    Footnotes
    1 Xueli Sun and Ling Gao contributed to this work equally.
    Affiliations
    Department of Endocrinology, Clinical Medical College, Yangzhou University, 98 Nantong West Road, Yangzhou 225001, China
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  • Yan Liu
    Affiliations
    Department of Endocrinology, Clinical Medical College, Yangzhou University, 98 Nantong West Road, Yangzhou 225001, China
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  • Wei Huang
    Affiliations
    Center of Health Management, Clinical Medical College, Yangzhou University, 98 Nantong West Road, Yangzhou 225001, China
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  • Changjun Pei
    Affiliations
    Center of Health Management, Clinical Medical College, Yangzhou University, 98 Nantong West Road, Yangzhou 225001, China
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  • Xin Wang
    Affiliations
    Center of Health Management, Clinical Medical College, Yangzhou University, 98 Nantong West Road, Yangzhou 225001, China
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  • Shangyong Feng
    Correspondence
    Corresponding author. Department of Endocrinology, Clinical Medical College, Yangzhou University, 98 Nantong West Road Yangzhou 225001, China. Tel.: +86 514-8737-3375.
    Affiliations
    Department of Endocrinology, Clinical Medical College, Yangzhou University, 98 Nantong West Road, Yangzhou 225001, China
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  • Bin Song
    Correspondence
    Corresponding author. Department of Chronic Diseases Management, Clinical Medical College, Yangzhou University, 98 Nantong West Road Yangzhou 225001, China. Tel.: +86 514-8737-3608.
    Affiliations
    Department of Chronic Disease Management, Clinical Medical College, Yangzhou University, 98 Nantong West Road, Yangzhou 225001, China
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  • Author Footnotes
    1 Xueli Sun and Ling Gao contributed to this work equally.
Published:November 19, 2022DOI:https://doi.org/10.1016/j.numecd.2022.11.018
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      Highlights

      • ABSI had a linear and positive association with total and cardiovascular mortality in diabetes.
      • ABSI showed a higher all-cause and cardiovascular mortality risk among men and young patients.
      • Both sex and age modified the association of ABSI and all-cause mortality.

      Abstract

      Background and Aims

      Evidence regarding the effect of body shape index (ABSI) on mortality is scarce among individuals with diabetes mellitus (DM). Herein, we explored the relationships between ABSI and all-cause and cardiovascular death risks among US individuals with DM.

      Methods and Results

      A total of 4657 US adults with DM were enrolled from the National Health and Nutrition Examination Survey (NHANES 2003-2014) who had baseline waist circumference, height, and weight data. ABSI was calculated as W C × w e i g h t 2 / 3 × h e i g h t 5 / 6 and the survival information of patients was available from recruitment until 2015 utilizing the national death index. We employed Cox proportional hazards models to estimate the association of ABSI with survival. A total of 817 adults with DM died after a median follow-up period of 5.6 years, with an annual all-cause death rate per 1000 person-years of 30.0 [95% CI, 28.0-32.1]. Continuous ABSI z score was positively and significantly associated with all-cause mortality with adjustment for potential confounders (HR= 1.16, 95% CI: 1.06–1.28). ABSI tended to show a higher all-cause and CVD (cardiovascular disease) mortality among men (HR= 1.35, 95% CI: 1.19–1.53 and HR= 1.45, 95% CI: 1.12–1.87, respectively) and patients younger than 60 years (HR= 1.45, 95% CI: 1.16–1.80 and HR= 1.66, 95% CI: 1.09–2.53, respectively). Statistically significant interactions were found between the ABSI and both sex and age for total mortality

      Conclusions

      Among US adults with DM from NHANES, ABSI exhibited a linear and positive relationship with total and CVD mortality risk, especially in men and younger patients.

      Keywords

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