Abstract MP82: Body Mass Index and Mortality in Chinese Adults with Newly Diagnosed Type 2 Diabetes

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Noel T Mueller ◽  
Andrew O Odegaard ◽  
Woon-Puay Koh ◽  
Myron D Gross ◽  
Jian-Min Yuan ◽  
...  

In Western populations normal weight adults at the time of incident type 2 diabetes (T2D) diagnosis have been reported to have higher mortality risk than overweight/obese adults. However, little investigation of this topic has occurred in Asian populations who tend to have relatively low body mass index (BMI = kg/m2) yet high rates of T2D. We investigated the association between BMI, reported prior to diagnosis of T2D, and mortality risk among a cohort of Chinese adults with T2D.We used data from the Singapore Chinese Health Study, including Chinese men and women aged 45-74 years of age, free of cancer, heart disease, stroke, and T2D at baseline (1993-1998), and followed for mortality through 2011. A total of 4,288 participants, contributing 57,220 person-years of follow-up, reported physician diagnosed incident T2D at two follow up interviews and reported height and weight at the previous interview, an average of 4.4 years prior to T2D diagnosis. Participants were classified according to WHO Asian-specific definitions as underweight (BMI <18.5), normal weight (18.5-23.49), overweight (23.5-27.49), and obese (≥ 27.5).During an average follow-up of 13.3 years, 470 of the 4,288 participants died: 159 from cardiovascular (CVD) causes and 311 from other causes. After adjustment for demographics, smoking status and alcohol consumption, there were no statistically significant differences in mortality rates across the BMI categories. However, the BMI-mortality association varied markedly by age. Among those who were ≤65 years of age, obesity, compared to normal weight, carried an increased risk of total mortality by 41% (4% to 92%) and of CVD mortality by 56% (-9% to 166%). However, among those >65 years of age we observed no association between BMI and mortality risk. Among Singaporean Chinese adults with type 2 diabetes, being obese prior to diagnosis was associated with increased risk of death in those who were ≤65 years of age, whereas among those >65 years there was no clear association between BMI and risk of mortality.

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
wenhui zhao ◽  
Peter Katzmarzyk ◽  
Ronald Horswell ◽  
Yujie Wang ◽  
Jolene Johnson ◽  
...  

Background: Several prospective studies have evaluated the association between body mass index (BMI) and the risk of all-cause mortality among diabetic patients; however, the results are controversial. Aim: To investigate the association of BMI levels with all-cause mortality among patients with type 2 diabetes in the Louisiana State University Hospital-based Longitudinal study (LSUHLS). Methods: We performed a prospective cohort study (2000-2009) of diabetic patients including 19,785 African Americans and 15,534 whites. Cox proportional hazards regression models were used to estimate the association of BMI levels at baseline, during follow-up and at last visit with the risk of all-cause mortality. Results: During a mean follow up of 8.7 years, 4,206 deaths were identified. The multivariable-adjusted (age, sex, smoking, income and type of insurance) hazard ratios (HRs) of all-cause mortality associated with BMI levels (<23, 23-24.9, 25-29.9, 30-34.9 [reference group], 35-39.9, and ≥40 kg/m 2 ) at baseline were 2.53 (95% confidence interval [CI] 2.18-2.93), 1.76 (1.48-2.09), 1.23 (1.08-1.40), 1.00, 1.19 (1.02-1.38), and 1.22 (1.05-1.41) for African Americans, and 1.92 (1.63-2.27), 1.53 (1.28-1.82), 1.07 (0.95-1.21), 1.00, 1.07 (0.93-1.23), and 1.21 (1.06-1.39) for whites, respectively. When stratified by age, gender, smoking status or use of anti-diabetic drugs, a U-shaped association was still present. When we used an updated mean or last visit value of BMI, the U-shaped association of BMI with all-cause mortality risk did not change. Conclusions: The current study indicated a U-shaped association of BMI with all-cause mortality risk among African American and white patients with type 2 diabetes. A significantly increased risk of all-cause mortality was observed among African Americans with BMI<30 kg/m 2 and BMI ≥35 kg/m 2 , and among whites with BMI<25 kg/m 2 and BMI ≥40 kg/m 2 compared with patients with BMI 30-34.9 kg/m 2 .


2019 ◽  
Vol 6 (6) ◽  
pp. 1788
Author(s):  
Rakesh K. Sisodia ◽  
Mahendra Chouhan

Background: Obesity has major adverse effects on health. Obesity is associated with an increase in mortality, with a 50-100% increased risk of death from all causes compared to normal-weight individuals, mostly due to cardiovascular causes. The aim of this study was to correlate Body Mass Index (BMI) and glycaemic control (HbA1c) in type 2 Diabetic patients.Methods: In this study 100 patients of type 2 diabetic were subjected to detailed history, clinical examination, BMI, HbA1c and routine biochemical investigations.Results: Out of 100 diabetic patients included in this study 62 of them were male and 38 were female. Among 100 patients. Majority of patients were overweight (BMI 25-29.9) which is account to about 58 of total cases, 30 patients were normal BMI and 12 patients were obese. Statistical analysis a positive correlation found between BMI and poor glycaemic control (HbA1c), which is significant.Conclusions: From this study it was concluded that obesity (BMI) is associated with poor glycaemic control.


Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 2086-P
Author(s):  
ERIC NYLEN ◽  
PETER KOKKINOS ◽  
CHARLES FASELIS ◽  
PUNEET NARAYAN ◽  
PAMELA KARASIK ◽  
...  

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Sae Young Jae ◽  
Mercedes Carnethon ◽  
Won Hah Park ◽  
Bo Fernhall

There is conflicting evidence regarding the association between metabolically healthy obese (MHO) and metabolically unhealthy normal weight (MUNW) with incident hypertension and type 2 diabetes. The role of cardiorespiratory fitness on these associations has not been fully explored. We tested the hypothesis that obesity phenotypes predict incident hypertension and type 2 diabetes, but cardiorespiratory fitness modifies these associations in a prospective study of apparently healthy men. 3800 men (mean age 48±6 yrs, range 20-76 yrs) participated in two health examinations during 1998-2009. All subjects were free of hypertension and type 2 diabetes at baseline examination. MHO was defined as obesity (body mass index ≥ 25 kg/m2) with no more than one metabolic abnormality, and MUNW was defined as body mass index < 23 kg/m2) with two or more abnormalities. Cardiorespiratory fitness was directly measured by peak oxygen uptake during a treadmill test. Incident hypertension and type 2 diabetes were defined as blood pressure ≥140/90mmHg and as ≥6.5% of HbA1c or ≥126mg/dl of fasting glucose at second examination, respectively. During an average follow-up of 5 years (1-12 yrs), there were 371 (9.8%) men incident hypertension and 170 (4.5%) men incident type 2 diabetes. MHO and MUNW were present in 844 (22%) and 249 (6.6%) men. Compared with metabolically healthy normal weight men, MHO and MUNW men were at increased risk for hypertension (relative risk (RR) =1.82, 95% Confidence Interval (CI): 1.29-2.56 and 1.75, 1.11-2.74) and type 2 diabetes (RR=3.68, 1.92-7.07 and 5.35, 2.61-10.94), respectively. These risks in MHO and MUNW men were still persisted with adjustment for confounder variables and cardiorespiratory fitness (hypertension=1.57, 1.05-2.34 and 1.59, 1.01-2.51; type 2 diabetes=3.35, 1.63-6.89 and 4.76, 2.32-9.77). Metabolically healthy obese or metabolically unhealthy normal weight men were at increased risk of hypertension and type 2 diabetes compared with metabolically healthy normal weight men. However, these associations were not attenuated by cardiorespiratory fitness or other confounder factors.


2020 ◽  
Vol 8 (1) ◽  
pp. e000879
Author(s):  
Baibing Mi ◽  
Chenlu Wu ◽  
Xiangyu Gao ◽  
Wentao Wu ◽  
Jiaoyang Du ◽  
...  

IntroductionTo investigate the relationship between long-term change trajectory in body mass index (BMI) and the hazard of type 2 diabetes among Chinese adults.Research design and methodsData were obtained from the China Health and Nutrition Survey (CHNS). Type 2 diabetes was reported by participants themselves in each survey wave. The duration of follow-up was defined as the period from the first visit to the first time self-reported type 2 diabetes, death, or other loss to follow-up from CHNS. The patterns of change trajectories in BMI were derived by latent class trajectory analysis method. The Fine and Gray regression model was used to estimate HRs with corresponding 95% CIs for type 2 diabetes.ResultsFour patterns of the trajectories of change in BMI were identified among Chinese adults, 42.7% of participants had stable BMI change, 40.8% for moderate BMI gain, 8.9% for substantial BMI gain and 7.7% for weight loss. During the follow-up with mean 11.2 years (158 637 person-years contributed by 14 185 participants), 498 people with type 2 diabetes (3.7%) occurred. Risk of type 2 diabetes was increased by 47% among people who gained BMI more substantially and rapidly (HR: 1.47, 95% CI 1.08 to 2.02, p=0.016) and increased by 20% among those in people with the moderate BMI gain (HR: 1.20, 95% CI 0.98 to 1.48, p=0.078), compared with those with stable BMI change.ConclusionsLong-term substantial gain of BMI was significantly associated with an increased risk of type 2 diabetes in the Chinese adults.


2017 ◽  
Vol 04 (01) ◽  
pp. e1-e4
Author(s):  
Gottfried Rudofsky ◽  
Tanja Haenni ◽  
John Xu ◽  
Eva Johnsson

Abstract Genital infections are associated with sodium glucose co-transporter 2 inhibitors such as dapagliflozin. Since patients with Type 2 diabetes are at increased risk of genital infections, and obesity is a risk factor for infections, obese patients with Type 2 diabetes could be more susceptible to genital infections when treated with sodium glucose co-transporter 2 inhibitors. This pooled dataset assessed the frequency of genital infections according to baseline body mass index in patients treated with dapagliflozin 10 mg. Data were pooled from 13 studies of up to 24 weeks’ duration (dapagliflozin N=2 360; placebo N=2 295). Frequency of genital infections was compared between three body mass index subgroups (<30, ≥30−< 35 and ≥35 kg/m2). Genital infections were reported in 130 (5.5%) patients receiving dapagliflozin and 14 (0.6%) patients receiving placebo; none of which were serious. Genital infections were more common in women (84/130 [64.6%]) than in men (46/130 [35.4%]) treated with dapagliflozin. In the body mass index < 30, ≥ 30−< 35 and ≥ 35 kg/m2 dapagliflozin-treated subgroups, 38/882 (4.3%), 47/796 (5.9%) and 45/682 (6.6%) patients presented with genital infections, respectively. Although the frequency was low overall and relatively similar between subgroups, there was a trend towards an increase in genital infections in patients with a higher body mass index. This trend is unlikely to be clinically relevant or to affect suitability of dapagliflozin as a treatment option for obese patients with Type 2 diabetes, but rather should influence advice and counselling of overweight patients on prevention and treatment of genital infections.


2017 ◽  
Vol 43 ◽  
pp. 46-52 ◽  
Author(s):  
M.A. Salinero-Fort ◽  
F.J. San Andrés-Rebollo ◽  
P. Gómez-Campelo ◽  
C. de Burgos-Lunar ◽  
J. Cárdenas-Valladolid ◽  
...  

2019 ◽  
Vol 54 (4) ◽  
pp. 291-296
Author(s):  
Rachel J Burns

Abstract Background Body mass index (BMI) is linked to Type 2 diabetes (T2D). Although romantic partners influence each other's health outcomes, it is unclear if partner's BMI is related to the development of T2D. Purpose To test prospective, dyadic associations between BMI and the development of T2D in middle-aged and older adult couples over 8 years. Methods Data came from 950 couples in the Health and Retirement Study. Neither partner had diabetes at baseline (2006). The actor–partner interdependence model was used to examine dyadic associations between BMI at baseline and the development of T2D during the next 8 years. Results After adjusting for covariates, a significant actor effect was observed such that one's BMI at baseline was positively associated with one's own odds of developing T2D during follow-up (odds ratio [OR] = 1.08, p &lt; .001). A significant partner effect was also observed such that the BMI of one's partner at baseline was positively associated with one's own odds of developing T2D during follow-up above and beyond one's own baseline BMI (OR = 1.04, p = .003). These associations were not moderated by sex. This pattern of results held when BMI was coded categorically (not overweight/obese; overweight; obese). Conclusions Partner's BMI was prospectively associated with the likelihood of developing T2D. Future research should consider interpersonal risk factors for chronic health conditions, such as T2D. There is an opportunity to develop theoretical models that specify how and when partner characteristics are linked to physical morbidity.


Author(s):  
Maddalena Ardissino ◽  
Eric A.W. Slob ◽  
Ophelia Millar ◽  
Rohin K. Reddy ◽  
Laura Lazzari ◽  
...  

Background: Maternal cardiovascular risk factors have been associated with adverse maternal and fetal outcomes. Given the difficulty in establishing causal relationships using epidemiological data, we applied Mendelian randomization to explore the role of cardiovascular risk factors on risk of developing preeclampsia or eclampsia, and low fetal birthweight. Methods: Uncorrelated single-nucleotide polymorphisms associated systolic blood pressure (SBP), body mass index, type 2 diabetes, LDL (low-density lipoprotein) with cholesterol, smoking, urinary albumin-to-creatinine ratio, and estimated glomerular filtration rate at genome-wide significance in studies of 298 957 to 1 201 909 European ancestry participants were selected as instrumental variables. A 2-sample Mendelian randomization study was performed with primary outcome of preeclampsia or eclampsia (PET). Risk factors associated with PET were further investigated for their association with low birthweight. Results: Higher genetically predicted SBP was associated increased risk of PET (odds ratio [OR] per 1-SD SBP increase 1.90 [95% CI=1.45–2.49]; P =3.23×10 −6 ) and reduced birthweight (OR=0.83 [95% CI=0.79–0.86]; P =3.96×10 −18 ), and this was not mediated by PET. Body mass index and type 2 diabetes were also associated with PET (respectively, OR per 1-SD body mass index increase =1.67 [95% CI=1.44–1.94]; P =7.45×10 −12 ; and OR per logOR increase type 2 diabetes =1.11 [95% CI=1.04–1.19]; P =1.19×10 −3 ), but not with reduced birthweight. Conclusions: Our results provide evidence for causal effects of SBP, body mass index, and type 2 diabetes on PET and identify that SBP is associated with reduced birthweight independently of PET. The results provide insight into the pathophysiological basis of PET and identify hypertension as a potentially modifiable risk factor amenable to therapeutic intervention.


Author(s):  
Ю.Э. Азарова ◽  
Е.Ю. Клёсова ◽  
А.В. Полоников

Ожирение является важнейшим фактором риска развития сахарного диабета 2 типа (СД2). Гепатоцитарный ядерный фактор 1 β (HNF1B) контролирует глюкостатическую функцию островков Лангерганса поджелудочной железы и ассоциирован с развитием СД2 в европейской и азиатской популяциях. Однако исследований, оценивающих роль генетических вариантов HNF1B в формировании предрасположенности к СД2 в русской популяции, на сегодняшний день не проводилось. Целью настоящей работы стало изучение ассоциации полиморфного варианта rs4430796 (A>G) в интроне гена HNF1B с показателями гликемического профиля и редокс-гомеостаза, а также риском развития СД2 у жителей Центральной России, с учетом их пола и индекса массы тела. В исследование включено 3206 человек, из них 1579 больных СД2 и 1627 условно здоровых добровольцев. Генотипирование проводили с использованиеми технологии iPLEX на геномном времяпролетном масс-спектрометре MassArray 4 (Agena Bioscience). Впервые в русской популяции установлена взаимосвязь полиморфизма rs4430796 гена HNF1B с повышенным риском развития СД2 (OR 1,24, 95CI 1,05-1,47, р=0,011). Стратифицированный анализ по полу обнаружил, что выявленная ассоциация характерна только для женщин с избыточной массой тела (OR 1,54, 95CI 1,06-2,22, р=0,02) и ожирением (OR 2,07, 95CI 1,14-3,77, р=0,047) и отсутствует у лиц с нормальной массой тела вне зависимости от пола. Изучаемый SNP ассоциирован с повышенным содержанием перекиси водорода (р=0,012) и более низким уровнем общего глутатиона плазмы (р=0,041) у женщин, тогда как у мужчин с СД2 генотип G/G связан со снижением концентрации С-пептида (р=0,004) и повышением концентрации глюкозы крови (р=0,015). Биоинформатический анализ подтвердил отрицательный эффект аллеля G на экспрессию HNF1B, а также выявил его связь с гиперметилированием гена в различные периоды жизни, что обусловливает низкую экспрессию гена HNF1B у носителей минорного аллеля rs4430796-G. Таким образом, нами впервые установлено, что полиморфный вариант гена HNF1B rs4430796 ассоциирован с предрасположенностью к СД2 в русской популяции, при этом его связь с заболеванием имеет пол-специфический характер и зависит от индекса массы тела. Obesity is a critical risk factor for type 2 diabetes mellitus (T2D). Hepatic nuclear factor 1 β (HNF1B) controls the glucostatic function of pancreatic islets of Langerhans and is associated with the development of T2D in the European and Asian populations. However, studies evaluating the contribution of genetic variants at HNF1B to the pathogenesis of the disease in Russian population have not been conducted to date. The aim of this work was to study the association of the polymorphic variant rs4430796 (A>G) in the intron of the HNF1B gene with parameters of glycemic profile and redox homeostasis, as well as the risk of developing T2D in citizens of Central Russia, taking into account their gender and body mass index. The study included 3206 participants, 1579 patients with T2D and 1627 healthy volunteers. Genotyping was performed using iPLEX technology on a genomic time-of-flight mass spectrometer MassArray 4 (Agena Bioscience). For the first time in the Russian population, the relationship of the rs4430796 polymorphism at the HNF1B gene with an increased risk of developing T2D (OR 1,24, 95CI 1,05-1,47, p=0,011) was established. A gender-stratified analysis found that the association is characteristic only for females with overweight (OR 1,54, 95CI 1,06-2,22, p=0,02) and obesity (OR 2.07, 95CI 1,14-3,77, p=0.047) and is absent in individuals with normal body weight, regardless from the gender. The studied SNP is associated with an increased content of hydrogen peroxide (p=0,012) and a lower level of total plasma glutathione (p=0,041) in females, whereas in diabetic males the G/G genotype is associated with a decrease in the concentration of C-peptide (p=0,004) and an increase in blood glucose concentration (p=0,015). Bioinformatic analysis confirmed the negative effect of the alternative G allele on the expression of the HNF1B gene, as well as its relationship with hypermethylation of the gene at different periods of life, which leads to low expression of HNF1B in carriers of variant rs4430796. Conclusions: It was found for the first time that the polymorphic variant rs4430796 of the HNF1B gene is associated with a predisposition to T2D, whereas its relationship with the disease is sex-specific and depends on body mass index.


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