Nutrition, metabolism, and cardiovascular diseases : NMCD · 2025
Association and predictive value of cumulative weight-adjusted waist index with all-cause mortality in type 2 diabetes: Insights from the ACCORD study.
СтатьяМногоцентровое исследованиеРандомизированное исследованиеНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Liu Maojun, Pei Junyu, Zeng Cheng, Xin Ying, Tang Peiqi, Hu Xinqun
Аннотация
BACKGROUND AND AIM: Recent studies have identified the weight-adjusted waist index (WWI) as a novel anthropometric measure strongly associated with metabolic diseases and mortality. However, it remains unclear whether cumulative exposure to WWI influences the risk of all-cause mortality among patients with type 2 diabetes mellitus (T2DM).This study aims to assess how baseline WWI and cumulative WWI are linked to all-cause mortality in patients with T2DM and their predictive value.
METHODS AND RESULTS: This study used data from the ACCORD/ACCORDION clinical trial. Baseline WWI and cumulative WWI were calculated for the first three follow-up visits. The Kaplan-Meier survival curve and the Cox proportional hazards regression model were employed to investigate the relationship between WWI and all-cause mortality. RCS and smooth curve fitting techniques were employed to find possible nonlinear associations. Predictive ability was assessed via AUC, NRI, and IDI. Over 6.61 median follow-up years, 1274 deaths occurred. Each 1-unit increase in baseline and cumulative WWI raised mortality risk by 15 % (HR = 1.15, 95 % CI: 1.06-1.24) and 8 % (HR = 1.08, 95 % CI: 1.05-1.11), respectively. Highest WWI quartiles had 1.29-fold (baseline) and 1.49-fold (cumulative) higher mortality risks. Cumulative WWI showed a linear association with mortality risk, while baseline WWI exhibited a U-shaped relationship (inflection point: 10.236). Cumulative WWI had superior predictive ability.
CONCLUSIONS: WWI independently predicts mortality in T2DM patients, with cumulative WWI being more stable and predictive. WWI may serve as an additional factor to be considered for long-term risk stratification and personalized management in T2DM.
METHODS AND RESULTS: This study used data from the ACCORD/ACCORDION clinical trial. Baseline WWI and cumulative WWI were calculated for the first three follow-up visits. The Kaplan-Meier survival curve and the Cox proportional hazards regression model were employed to investigate the relationship between WWI and all-cause mortality. RCS and smooth curve fitting techniques were employed to find possible nonlinear associations. Predictive ability was assessed via AUC, NRI, and IDI. Over 6.61 median follow-up years, 1274 deaths occurred. Each 1-unit increase in baseline and cumulative WWI raised mortality risk by 15 % (HR = 1.15, 95 % CI: 1.06-1.24) and 8 % (HR = 1.08, 95 % CI: 1.05-1.11), respectively. Highest WWI quartiles had 1.29-fold (baseline) and 1.49-fold (cumulative) higher mortality risks. Cumulative WWI showed a linear association with mortality risk, while baseline WWI exhibited a U-shaped relationship (inflection point: 10.236). Cumulative WWI had superior predictive ability.
CONCLUSIONS: WWI independently predicts mortality in T2DM patients, with cumulative WWI being more stable and predictive. WWI may serve as an additional factor to be considered for long-term risk stratification and personalized management in T2DM.