School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
BMJ Open Diabetes Res Care. 2023 Aug;11(4). doi: 10.1136/bmjdrc-2023-003474.
A body shape index (ABSI) is independently associated with mortality in general population, but studies on the predictability of ABSI in the risk of mortality in patients with type 2 diabetes (T2D) are limited. We aimed to examine the independent and joint association of ABSI, body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), and body roundness index (BRI) with mortality in patients with T2D.
The study included 11 872 patients (46.5% women) aged 30 years and older and who took part in diabetes care management program of a medical center in Taiwan. Body indices were evaluated by anthropometric measurements at baseline between 2001 and 2016, and their death status was followed up through 2021. Multivariate Cox regression models were used to assess the effect of body indices on mortality.
During a mean follow-up of 10.2 years, 560 cardiovascular disease (CVD) deaths and 3043 deaths were recorded. For ABSI, WC, WHR, WHtR and BRI, all-cause mortality rates were statistically significantly greater in Q4 versus Q2. For BMI and WHtR, all-cause mortality rates were also statistically significantly greater in Q1 versus Q2. The combination of BMI and ABSI exhibited a superiority in identifying risks of all-cause mortality and CVD mortality (HRs: 1.45 and 1.37, both p<0.01).
Combined use of ABSI and BMI can contribute to the significant explanation of the variation in death risk in comparison with the independent use of BMI or other indices.
身体形态指数（ABSI）与一般人群的死亡率独立相关，但关于 ABSI 预测 2 型糖尿病（T2D）患者死亡率的研究有限。我们旨在研究 ABSI、体重指数（BMI）、腰围（WC）、腰臀比（WHR）、腰高比（WHtR）和体圆度指数（BRI）与 T2D 患者死亡率的独立和联合关联。
这项研究纳入了 11872 名年龄在 30 岁及以上并参加台湾一家医疗中心糖尿病护理管理计划的患者（46.5%为女性）。在 2001 年至 2016 年期间，通过人体测量学测量评估了身体指数，并通过 2021 年的死亡情况进行了随访。多变量 Cox 回归模型用于评估身体指数对死亡率的影响。
在平均 10.2 年的随访期间，记录了 560 例心血管疾病（CVD）死亡和 3043 例死亡。对于 ABSI、WC、WHR、WHtR 和 BRI，Q4 与 Q2 相比，全因死亡率具有统计学显著差异。对于 BMI 和 WHtR，Q1 与 Q2 相比，全因死亡率也具有统计学显著差异。BMI 和 ABSI 的组合在识别全因死亡率和 CVD 死亡率风险方面表现出优势（HR：1.45 和 1.37，均<0.01）。
与单独使用 BMI 或其他指数相比，ABSI 和 BMI 的联合使用可以显著解释死亡风险的变化。
