Hong S, Park JH, Han K, et al. - Among elderly patients with diabetes, body mass index (BMI) was identified as an inadequate risk indicator for outcomes associated with obesity but waist circumference (WC) afforded an appropriate alternative.

• In this retrospective observational study with a mean follow-up of 7.26 years, a total of 249,903 elderly (≥65 years) patients with type 2 diabetes mellitus and no pre-existing cardiovascular disease were included.

• The primary outcome (a composite of stroke, myocardial infarction, and all-cause death) risk had an L-shaped and a U-shaped link with BMI and WC, respectively.

• Multivariable Cox proportional hazard models showed a lower risk of primary composite outcomes in the highest BMI group (≥30 kg/m 2; hazards ratio [HR]=0.824) vs in the normal BMI group (≥18.5 and <23 kg/m 2).

• The risk was higher in the highest WC group (≥100 cm/≥95 cm; men/women; HR=1.434) vs the normal WC group (<90 cm/<85 cm; men/women).