RESEARCH DESIGN AND METHODS

OBJECTIVEdWe aimed to determine the associations of waist circumference (WC) and BMI with all-cause mortality among patients with diabetes. RESEARCH DESIGN AND METHODSdThe sample included 847 white and 553 Af-rican American patients (18–69 years of age) with diabetes. Height, weight, and WC were measured, and the BMI (kg/m2) was calculated. Cox regression was used to analyze the associ-ations of BMI and WC with mortality, adjusting for age, sex, race, examination year, smoking status, alcohol consumption, and physical activity. Hazard ratios (HRs) are expressed per stan-dard deviation of each independent variable. RESULTSdA total of 86 deaths occurred during 6.7 years of follow-up. After adjustment for covariates, WC (HR 1.40 [95 % CI 1.14–1.72]) and BMI (1.29 [1.04–1.61]) demonstrated sig-nificant relationships with mortality. CONCLUSIONSdThe results indicate that maintaining a healthy WC and BMI are both important for individuals living with diabetes. The number of individuals in the U.S.living with diabetes continues to rise(1), and these patients have an in-creased risk of cardiovascular complica-tions and premature mortality (2). Obesity is associated with the develop-ment of type 2 diabetes (3,4); however, the relationship between the most com-mon measure of obesity, the BMI, and mortality among patients with diabetes is less clear. To date, studies have reported positive associations (5), negative asso-ciations (6–9), U-shaped associations (10,11), or no association (12) between BMI and mortality among patients with diabetes. However, the BMI has some limitations as an indicator of obesity (13), and no study has been reported on the relationship with other indica-tors of adiposity. Thus, the purpose of this prospective cohort study was to determine the associations of waist circumference (WC) and BMI with all-cause mortality