| Title: | Weight-adjusted-waist index, estimated glucose disposal rate, C-reactive protein, and mortality risks among individuals with type 2 diabetes: 2 prospective cohort studies in China and the United Kingdom |
| Journal: | American Journal of Clinical Nutrition |
| Published: | 13 Sep 2025 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/40953704/ |
| DOI: | https://doi.org/10.1016/j.ajcnut.2025.09.018 |
Publication 19503
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Abstract
BACKGROUND: Weight-adjusted-waist index (WWI) is an anthropometric index reflecting fat mass and muscle mass, both of which are important factors influencing insulin resistance and inflammation.</p>
OBJECTIVES: We aimed to examine the associations of WWI with all-cause, cardiovascular, and noncardiovascular mortality among individuals with type 2 diabetes (T2D) and further investigate whether insulin resistance and inflammation, measured by estimated glucose disposal rate (eGDR) and C-reactive protein (CRP) respectively, can mediate these associations.</p>
METHODS: Participants with T2D from 2 prospective cohorts, the China Changshu Cohort of Type 2 Diabetes (CT2D) (N = 10,157) and UK Biobank (UKB) (N = 25,019), were included. WWI was calculated as waist circumference divided by the square root of body weight.</p>
RESULTS: In CT2D, participants in the highest WWI quartile had higher risks of all-cause mortality (hazard ratio [HR]: 1.64; 95% confidence interval [CI]: 1.44, 1.86), cardiovascular mortality (HR: 1.51; 95% CI: 1.20, 1.89), and noncardiovascular mortality (HR: 1.71; 95% CI: 1.47, 2.00) compared with those in the lowest quartile. In UKB, the corresponding HRs for all-cause mortality, cardiovascular mortality, and noncardiovascular mortality were 1.55 (95% CI: 1.42, 1.70), 1.80 (95% CI: 1.52, 2.13), and 1.46 (95% CI: 1.31, 1.62), respectively. WWI also showed better predictive ability than many current obesity indicators in both cohorts. Furthermore, eGDR mediated the relation between WWI and all-cause, cardiovascular, and noncardiovascular mortality by 16.20% (95% CI: 6.77, 27.63), 57.92% (95% CI: 33.52, 115.98), and 1.03% (95% CI: -9.96, 11.95) in CT2D and by 23.70% (95% CI: 15.60, 34.57), 38.02% (95% CI: 23.89, 59.19), and 16.06% (95% CI: 5.51, 29.55) in UKB, respectively. In UKB, the mediation proportions of CRP for all-cause, cardiovascular, and noncardiovascular mortality were 8.75% (95% CI: 6.23, 12.18), 7.64% (95% CI: 4.40, 12.73), and 9.38% (95% CI: 6.20, 13.91), respectively.</p>
CONCLUSIONS: High WWI levels are associated with increased risks of all-cause, cardiovascular, and noncardiovascular mortality among individuals with T2D, and eGDR and CRP mediate these associations. Our study highlights the value of WWI in identifying high-risk individuals and the potential of monitoring eGDR and CRP concentration and intervening as needed to prevent mortality in individuals with T2D.</p>
17 Keywords
- Aged
- Blood Glucose
- Body Weight
- C-Reactive Protein
- Cardiovascular Diseases
- China
- Cohort Studies
- Diabetes Mellitus, Type 2
- Female
- Humans
- Insulin Resistance
- Male
- Middle Aged
- Prospective Studies
- Risk Factors
- United Kingdom
- Waist Circumference
10 Authors
- Yang Geng
- Shujun Gu
- Yulong Fan
- Xujia Lu
- Zhengyuan Zhou
- Ning Zhang
- Yalong Pei
- Xinmei Lu
- Yan Borné
- Chaofu Ke
1 Application
| Application ID | Title |
|---|---|
| 60651 | Patterns, outcomes and predictors of non-communicable diseases and multimorbidity |
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