Sex-Specific Associations Between Anthropometric Indices and Left Ventricular Hypertrophy in Middle-Aged and Elderly Individuals with Type 2 Diabetes Mellitus.

OBJECTIVE

To investigate the associations of anthropometric indicators and left ventricular hypertrophy (LVH) in middle-aged and elderly individuals with type 2 diabetes mellitus (T2DM).

METHODS

This was a cross-sectional study. A total of 3330 individuals were recruited from three tertiary hospitals across China between July 2018 and June 2023. Demographic characteristics, biochemical parameters, and echocardiographic measurements were systematically collected. Anthropometric indices, including body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), body adiposity index (BAI), body roundness index (BRI), and weight-adjusted-waist index (WWI) were calculated using standardized protocols. Multivariable binary logistic regression models were employed to evaluate the associations between anthropometric indices and LVH. The diagnostic accuracy was assessed using receiver operating characteristic (ROC) curve analysis.

RESULTS

Multivariable logistic regression analysis revealed that WHR (OR:1.128, 95% CI:1.043, 1.220) and BRI (OR:1.455, 95% CI:1.011, 2.094) were independently associated with increased LVH risk in middle-aged males. Among middle-aged females, BAI (OR:1.112, 95% CI:1.046, 1.182), WHtR (OR:1.048, 95% CI:1.007, 1.090), and BRI (OR:1.234, 95% CI:1.040, 1.465) demonstrated significant associations with LVH. However, in the elderly population, none of the variables showed a statistically significant association with LVH (P>0.05). ROC curve analysis identified WHR as the strongest predictor in middle-aged males (AUC:0.674, 95% CI:0.584, 0.764), whereas BAI exhibited the highest discriminatory accuracy among middle-aged females (AUC:0.578, 95% CI:0.523, 0.633).

CONCLUSION

Sex-specific associations between obesity indices and LVH were observed in middle-aged individuals with T2DM, necessitating distinct risk-stratification strategies: prioritizing abdominal obesity in males and comprehensive adiposity distribution in females. Notably, the broad relevance of BRI in both sexes highlights its clinical utility.