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General and Central Adiposity as Risk Factors for Cardiovascular-related Outcomes: REWIND Post Hoc

Obesity (Silver Spring, Md.), 2022-11, Vol.30, p.177-177 [Peer Reviewed Journal]

Copyright Blackwell Publishing Ltd. Nov 2022 ;ISSN: 1930-7381 ;EISSN: 1930-739X

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  • Title:
    General and Central Adiposity as Risk Factors for Cardiovascular-related Outcomes: REWIND Post Hoc
  • Author: Kan, Hong ; Franek, Edward ; Pais, Prem ; Basile, Jan ; Nicolay, Claudia ; Raha, Sohini ; Hickey, Ana ; Ahmad, Nadia ; Konig, Manige ; Gerstein, Hertzel
  • Subjects: Mortality ; Risk factors
  • Is Part Of: Obesity (Silver Spring, Md.), 2022-11, Vol.30, p.177-177
  • Description: Background: In clinical practice, anthropometric measures other than BMI are rarely measured yet may be more predictive of cardiovascular (CV) risk. We analyzed the placebo group of the REWIND CV outcomes trial to compare several anthropometric measures as baseline predictors for cardiovascular disease (CVD)-related outcomes in participants with type 2 diabetes. Methods: Data from the REWIND trial placebo group (N=4952) were analyzed. All participants had T2D, were aged >50, and had either a previous CV event or CV risk factors and a BMI of >23 kg/m2. Cox proportional hazard models were used to investigate if BMI, waist-to-hip ratio (WHR), and waist circumference (WC) were significant risk factors for major adverse CV events (MACE)-3, CVD-related mortality, all-cause mortality, and heart failure (HF). Models were adjusted for age and sex, and additional baseline factors selected by LASSO method. Results are presented for 1 standard deviation increase of the respective anthropometric factor. Results: There were 663 MACE-3 events, 346 CVD-related deaths, 592 all-cause deaths, and 226 events of HF during the median follow-up of 5.4 years. WHR and WC, but not BMI, were identified as independent risk factors for MACE-3 (hazard ratio [HR] for WHR: 1.11 [95% CI 1.03 to 1.21]; p=0.009; HR for WC: 1.12 [95% CI 1.02 to 1.22]; p=0.012). WC adjusted for hip circumference (HC) showed the strongest association with MACE-3 compared to WHR, WC, or BMI unadjusted for each other (HR: 1.25 [95% CI 1.06 to 1.49]; p=0.009). Results for CVD-related mortality and all-cause mortality were similar. HF was predicted by WC and BMI, but not WHR (HR for WC: 1.34 [95% CI 1.16 to 1.54]; p<0.001; HR for BMI: 1.33 [95% CI 1.17 to 1.50]; p<0.001). Conclusions: In this post hoc analysis of the REWIND placebo group, WHR and WC were predictors of MACE-3, CVD-related mortality, and all-cause mortality; BMI was not. These findings indicate the need for anthropometric measures that consider body fat distribution when assessing CV risk.
  • Publisher: Silver Spring: Blackwell Publishing Ltd
  • Language: English
  • Identifier: ISSN: 1930-7381
    EISSN: 1930-739X
  • Source: ProQuest Central
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