Adiposity markers and risk of coronary heart disease in patients with type 2 diabetes mellitus

BACKGROUND This cross-sectional study aimed to evaluating the association between body adiposity markers and high-risk of coronary heart disease (CHD) in patients with type 2 diabetes. METHODS Recent adiposity markers [waist-to-height ratio, conicity index (C-index) and body adiposity index] and traditional markers [BMI, waist circumference and waist-to-hip ratio (WHR)] were measured. The 10-year risk of fatal CHD was estimated according to UKPDS risk engine scores. Patients were divided into high (CHD risk ≥20%; n = 99) or low-moderate (CHD risk <20%; n = 321) risk groups. Multiple logistic regression models were performed to analyze associations between CHD risk (outcome) and adiposity markers. RESULTS A total of 420 patients with type 2 diabetes (61.9 ± 9.5 years; 53.5% females; HbA1c 7.6 ± 1.6%) were evaluated. The high risk group had greater proportions of elevated C-index and BMI values than patients with low-moderate risk. No between-group differences in other adiposity markers were observed. In multiple logistic regression models, only C-index values ≥1.35 were associated with CHD risk >20% (OR = 1.69; 95% CI 1.03-2.78; P = 0.039) after adjusting for confounders (sedentary lifestyle, diabetic nephropathy, serum creatinine, and diabetes duration). The association between WHR and CHD risk did not hold in this sample. CONCLUSIONS The C-index was the body adiposity marker best associated with high risk of fatal CHD in these patients with type 2 diabetes.