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Diabetes and Vascular Disease

SUN-601 - Revisiting the Association between Adiposity Markers and Cardiovascular Outcomes and All-Cause Mortality in Patients with Type 2 Diabetes

Sunday, June 14, 2026
9:00 AM - 4:00 PM CT
Location: ENDOExpo; Poster Floor


Introduction: Excess and/or dysfunctional adiposity is a trigger factor for the
cardiovascular-kidney-metabolic syndrome. BMI might not be sufficient to
identify these high-risk patients. In this context, a critical analysis of other
adiposity markers is of great relevance for the evaluation of special
populations, such as patients with type 2 diabetes.

Objective: To evaluate the
associations between adiposity markers (BMI, waist circumference, waist-to-
height ratio and total and trunk body fat) with cardiovascular events and with
all-cause mortality (CV composite outcomes) in patients with type 2 diabetes.

Methods: In this prospective cohort study, the patients were submitted to
clinical and nutritional evaluation. Clinical evaluation consisted of glycemic
and lipid profile, blood pressure control and the search for diabetic chronic
complications. Percentage body fat (PBF) was estimated by bioelectrical
impedance (InBody230, Biospace) and Dual Energy X-Ray Absorptiometry
(Lunar–iDXA). Cardiovascular events were considered: myocardial infarction,
myocardial revascularization procedures, congestive heart failure, new-onset
angina pectoris, stroke, and cardiovascular deaths.

Results: A total of 245
patients with type 2 diabetes (63±9 years; 59%M; 44% overweight and 43%
obese; follow up: 5.8 years) were evaluated. The group with CV composite
outcomes (n=71) presented a higher proportion of men (52 vs. 37%;
P=0.032), higher proportion of diabetic kidney disease (DKD; 51 vs. 45%;
P=0.049), lower serum levels of HDL cholesterol (41 vs. 44 mg/dl; P=0.02),
and lower values of PBF (35% vs. 38%; P=0.03). In Cox regression analysis,
only gender (male) (HR=2.17,95%CI:1.095–4.28; P=0.026) and presence of
basal established coronary heart disease (HR=1.76,95%CI:1.009–3.06;
P=0.046) were associated with CV composite outcomes, adjusting for
presence of DKD, serum HDL cholesterol, serum triglycerides, glycated
hemoglobin and basal PBF. No association was observed between adiposity
markers and CV composite outcomes.

Conclusion: In this sample of patients
with type 2 diabetes, we did not observe association between the analyzed
adiposity markers and adverse cardiovascular outcomes. This finding may be
due to their peculiar characteristics, such as the presence of obesity in more
than 40% of them, hindering the discriminatory power of adiposity markers.

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