JMIR Publications

ABSTRACT

Background:

Previous studies have confirmed the separate effect of arterial stiffness and obesity on type 2 diabetes; however, the joint effect of arterial stiffness and obesity on diabetes onset remains unclear.

Objective:

This study aimed to propose the concept of arterial stiffness obesity phenotype and explore the risk stratification capacity for diabetes.

Methods:

This retrospective cohort study used baseline data of 12298 participants from Beijing Xiaotangshan Examination Center between 2008 and 2013, and then annually followed until incident diabetes or 2019. Body mass index (waist circumstance) and brachial-ankle pulse wave velocity were measured to defined arterial stiffness (abdominal) obesity phenotype. Cox proportional hazard model was used to estimate hazard ratio (HR) and 95% confidence interval (CI).

Results:

The mean baseline age were 51.2±13.6 years and 8448 (68.7%) were male. After a median follow-up of 5.0 years, 1240 (10.1%) participants developed diabetes. Compared with the ideal vascular function and non-obese group, the highest risk of diabetes was observed in the elevated arterial stiffness and obese group (HR, 1.94; 95% CI, 1.60–2.35). Those of exclusive arterial stiffness or obesity exhibited similar risk of diabetes and the adjusted HRs were 1.63 (95% CI: 1.37-1.94) and 1.64 (95% CI: 1.32-2.04), respectively. Consistent results were observed in multiple sensitivity analyses and subgroups, and alternatively using arterial stiffness abdominal obesity phenotype.

Conclusions:

This study proposed the concept of arterial stiffness (abdominal) obesity phenotype, which could improve the risk stratification and management of diabetes. The clinical significance of arterial stiffness (abdominal) obesity phenotype needs further validation for other cardiometabolic disorders.