TOPLINE:

A higher waist-to-height ratio — a marker of central obesity — was associated with an increased risk for coronary artery disease (CAD) in adults with type 1 diabetes (T1D), independent of traditional risk factors; this association was more pronounced among those without albuminuria.

METHODOLOGY:

• Researchers in Finland analysed data of 4349 adults with T1D to examine whether the waist-to-height ratio is associated with CAD and whether albuminuria status affects this association.
• Included participants were adults (age ≥ 18 years) with T1D onset before the age of 40 years who initiated insulin therapy within 1 year of diagnosis; none of the participants had a history of CAD or had received kidney replacement therapy.
• The waist-to-height ratio was calculated as waist circumference divided by height; a value of 0.5 or higher indicated central obesity.
• Outcomes were newly developed CAD events, defined as acute myocardial infarction, coronary revascularisation, or death due to CAD; the median follow-up duration was 19.0 years.

TAKEAWAY:

• Overall, 15.3% of participants experienced incident CAD events; the 20-year cumulative incidence of CAD was 25.3% among those with central obesity vs 9.9% among those without (log-rank P < .001).
• After adjustment for sex, age at diabetes onset, duration of diabetes, A1c levels, systolic blood pressure, cholesterol, and smoking history, each 0.1-unit increase in the waist-to-height ratio was linked to a 21% higher risk for CAD (hazard ratio [HR], 1.21; P = .006).
• This association persisted among participants without albuminuria (HR, 1.26; P = .03), but it was not significant among those with moderate or severe albuminuria.

IN PRACTICE:

"WHtR [waist-to-height ratio] thus serves as a simple tool to refine cardiovascular disease risk stratification and potentially mitigate residual cardiovascular risk in type 1 diabetes," the authors wrote.

SOURCE:

This study was led by Erika Bezerra Parente and Fanny Jansson Sigfrids, Folkhälsan Research Center, Helsinki, Finland. It was published online on April 14, 2026, as a brief report in Diabetes Care.

LIMITATIONS:

This study was limited by the absence of cytokine data beyond high-sensitivity C-reactive protein values and the exclusion of angina pectoris or silent myocardial infarction from the CAD outcome.

DISCLOSURES:

The FinnDiane study was supported by grants from multiple organisations, including the Folkhälsan Research Foundation, Wilhelm and Else Stockmann Foundation, Finnish Medical Society, Liv och Hälsa Society, and Helsinki University Hospital. Several authors disclosed receiving lecture honoraria and investigator-initiated grants, being employed, and holding advisory board memberships with multiple companies, including Medscape.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.