Association of waist circumference with all-cause and cardiovascular mortality in diabetes from National Health and Nutrition Examination Survey 2003-2018

Introduction: 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 (3151 women and 3473 men) from NHANES 2003-2018 who had WC measurement at the baseline were included. The national death index was employed to obtain their survival data from the enrollment till 2019. The mortality risk was calculated using multivariable Cox proportional hazards models, smooth curve fitting, and threshold effect analysis. Results: Among a total of 6624 participants with diabetes, 621 women and 871 men died during the median follow-up of 6.8 and 6.3 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 0.97 (0.96–0.98) and 1.04 (1.02–1.05), respectively, among women; and those below and above 89.0 cm were 0.94 (0.90–0.97) and 1.03 (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.