Association of waist circumference with all-cause and cardiovascular mortality in diabetes from NHANES 2003-2014

Abstract Background In diabetes mellitus (DM), the relationship between waist circumference (WC) and mortality is scarce. Herein, we explored all-cause and cardiovascular mortality relationships with the baseline WC among individuals with DM. Methods US adults with DM (2256 women and 2427 men) from NHANES 2003–2014 who had WC measurement at the baseline were included. The national death index was employed to obtain their survival data from the enrollment till 2015. The mortality risk was calculated using multivariable Cox proportional hazards models, smooth curve fitting, and threshold effect analysis. Results Among a total of 4683 participants with diabetes, 346 women and 482 men died during the median follow-up of 5.7 and 5.4 years, respectively. With all-cause and cardiovascular mortality, WC exhibited a U-shaped association among females and a J-shaped trend among males. The adjusted hazard ratios (HRs) along with 95% confidence intervals (CIs) for all-cause mortality given WC values below and above 107.0 cm were 0.98 (0.96–0.98) and 1.03 (1.01–1.05), respectively, among women, and those below and above 89.5 cm were 0.91 (0.87–0.96) and 1.04 (1.02–1.05), respectively, among men. Conclusions WC presented a U-shaped relationship among women, and a J-shaped relation among men regarding all-cause and cardiovascular mortality among US adults with DM from NHANES.