Parente EB, Harjutsalo V, Forsblom C, et al. - The waist-to-height ratio (WHtR), a hallmark of central obesity, has been linked to severe diabetic eye disease (SDED) in people with type 1 diabetes.

• The authors investigated 3,468 of the 5,401 adults with T1D in the Finnish Diabetic Nephropathy Study, and 437 underwent dual-energy X-ray absorptiometry for body composition analysis.

• Eight hundred eighty-six SDED events occurred during a median follow-up of 14.5 (IQR 7.8-17.5) years.

• The visceral/android fat ratio, as well as the percentages of visceral and android fat, were linked to SDED, but not the total body fat percentage.

• The waist-height ratio was found to have the highest correlation with the risk of SDED, followed by the waist, BMI, and waist-hip ratio.

• The findings were comparable in normo- and microalbuminuria, but not in macroalbuminuria.

• At the normo- and microalbuminuria stages, a WHtR ≥ 0.5 raised the risk of SDED by 28%.