Relation Between Adiposity Measures and the Risk of a Composite of Cardiovascular Events, Diabetes, and Cancer in Patients With Cardiovascular Disease

Abstract

Adiposity contributes to multiple non-communicable diseases. To guide prevention of morbidity, this study aimed to quantify the relation between waist circumference (WC), body mass index (BMI), waist to height ratio (WtHR), abdominal subcutaneous (SAT) and visceral adipose tissue (VAT) and the risk of a composite outcome including recurrent cardiovascular events, incident type 2 diabetes and incident cancer, as well as each individual disease and all-cause mortality. Data were used from the UCC-SMART cohort study from 6138 patients with cardiovascular disease. Cox proportional hazard models estimated hazard ratios (HRs) and 95% confidence intervals (95% CIs) for adiposity measures, modelled as quartiles and per 1 SD increase, in relation to disease outcomes. All adiposity measures, except SAT, were related to higher risk of the composite outcome. WC and VAT showed the strongest relation (HR 1.62, 95% CI: 1.43, 1.83 and 1.62, 95% CI: 1.44, 1.83, respectively). Only WC and VAT were related to all-cause mortality (HRs 1.17, 95% CI: 1.01, 1.37 and 1.26, 95% CI: 1.08, 1.46, respectively). In patients with cardiovascular disease, WC and VAT are most strongly related to the risk of the composite outcome and to all-cause mortality. Monitoring adiposity with WC and VAT may help identify high-risk patients and could guide earlier interventions.