Apple-shaped bodies can lead to heart disease, and that reducing your waist size can reduce your risks. [Elev8]
Apple-shaped bodies can lead to heart disease, and that reducing your waist size can reduce your risks. [Elev8]

It turns out that weight around the abdomen—waist circumference—is a strong predictor of serious heart disease in patients with type 1 or type 2 diabetes, even absent information about body mass index (BMI) or total body weight. And this is true even if these patients have no existing symptoms of heart disease.

The finding comes from a study recently conducted by the Intermountain Medical Center Heart Institute in Salt Lake City and John Hopkins Hospital in Baltimore. Details were presented at the 2016 American College of Cardiology Scientific Session in Chicago on Saturday, April 2, in a talk entitled “Waist Circumference Is a Strong Predictor of Regional Left Ventricular Dysfunction in Asymptomatic Diabetic Patients: The Factor-64 Study.”

This new data complements a recent study that suggested clinicians move away from single metrics like BMI for determining overall patient health.

After evaluating 200 diabetic men and women who had not yet exhibited any coronary disease, the investigators determined that, even independently of total body weight and BMI, abdominal obesity was strongly associated with regional left ventricular (LV) dysfunction, a common cause of heart disease, including congestive heart failure. In LV dysfunction, blood backs up into the lungs and lower extremities; this impairment can lead to heart failure and sudden cardiac arrest.

“Our research examined patients with diabetes, who are considered high risk for developing heart disease already, and found that the shape of your body determined if you were at a greater risk to develop left ventricular dysfunction,” said J. Brent Muhlestein, M.D., co-director of research at the Intermountain Medical Center Heart Institute.

“This study confirms that having an apple-shaped body—or a high waist circumference—can lead to heart disease, and that reducing your waist size can reduce your risks,” added Dr. Muhlestein.

These results expand on those of a previously published study called faCTor-64, also conducted by researchers at Intermountain Medical Center Heart Institute and Johns Hopkins, which showed that the greater a person's BMI, the greater the risk of heart disease. Although any form of obesity can produce stress on the heart, the new study pinpoints abdominal obesity as strongly predictive of LV dysfunction.

“We specifically found that waist circumference appears to be a stronger predictor for LV dysfunction than total body weight or BMI,” noted Boaz D. Rosen, M.D., a cardiovascular specialist at Johns Hopkins and the current study's principal investigator. He cautioned, however, that further studies are needed to verify the new findings: “It will be important to see if these patients are indeed at risk of developing heart failure or coronary artery disease in the future.”

Diabetes is a major health problem in the United States. According to the CDC, 21 million Americans are diagnosed with the disease, and another 8.1 million are afflicted with the disease but remain undiagnosed. Among adults with diabetes, cardiovascular death rates are 1.7 times higher.

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