Abstract 06: Body Mass Index And The Risk Of All-cause Mortality Among Patients With Type 2 Diabetes

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
wenhui zhao ◽  
Peter Katzmarzyk ◽  
Ronald Horswell ◽  
Yujie Wang ◽  
Jolene Johnson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Body Mass Index ◽  
African Americans ◽  
Body Mass ◽  
Mortality Risk ◽  
Diabetic Patients ◽  
Increased Risk ◽  
All Cause Mortality

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 .

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 ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Body Mass Index ◽  
Body Mass ◽  
Mortality Risk ◽  
Normal Weight ◽  
Chinese Adults ◽  
Risk Of Death ◽  
Increased Risk

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.

Body mass index and all-cause mortality among type 2 diabetes mellitus patients: Findings from the 5-year follow-up of the MADIABETES cohort

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 ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Body Mass Index ◽  
Type 2 Diabetes Mellitus ◽  
Body Mass ◽  
All Cause Mortality

2086-P: The Interaction of Fitness, Body Mass Index, and Mortality Risk in Type 2 Diabetes

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 2086-P
Author(s):  
ERIC NYLEN ◽  
PETER KOKKINOS ◽  
CHARLES FASELIS ◽  
PUNEET NARAYAN ◽  
PAMELA KARASIK ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Body Mass Index ◽  
Body Mass ◽  
Mortality Risk

scholarly journals Frequency of Genital Infections According to Body Mass Index in Dapagliflozin-treated Patients with Type 2 Diabetes Mellitus

2017 ◽  
Vol 04 (01) ◽  
pp. e1-e4
Author(s):  
Gottfried Rudofsky ◽  
Tanja Haenni ◽  
John Xu ◽  
Eva Johnsson
Keyword(s):  
Type 2 Diabetes ◽  
Body Mass Index ◽  
Body Mass ◽  
The Body ◽  
Baseline Body Mass Index ◽  
Obese Patients ◽  
Genital Infections ◽  
Increased Risk ◽  
Three Body

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.

scholarly journals Association between On-Treatment Haemoglobin A1c and All-Cause Mortality in Individuals with Type 2 Diabetes: Importance of Personalized Goals and Type of Anti-Hyperglycaemic Treatment

2020 ◽  
Vol 9 (1) ◽  
pp. 246
Author(s):  
Emanuela Orsi ◽  
Enzo Bonora ◽  
Anna Solini ◽  
Cecilia Fondelli ◽  
Roberto Trevisan ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Haemoglobin A1c ◽  
Vital Status ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Severe Comorbidity ◽  
Potential Risks ◽  
Risk Of Treatment

The increased mortality reported with intensive glycaemic control has been attributed to an increased risk of treatment-related hypoglycaemia. This study investigated the relationships of haemoglobin (Hb) A1c, anti-hyperglycaemic treatment, and potential risks of adverse effects with all-cause mortality in patients with type 2 diabetes. Patients (n = 15,773) were stratified into four categories according to baseline HbA1c and then assigned to three target categories, based on whether HbA1c was ≤0.5% below or above (on-target), >0.5% below (below-target) or >0.5% above (above-target) their HbA1c goal, personalized according to the number of potential risks among age > 70 years, diabetes duration > 10 years, advanced complication(s), and severe comorbidity (ies). The vital status was retrieved for 15,656 patients (99.26%). Over a 7.4-year follow-up, mortality risk was increased among patients in the highest HbA1c category (≥8.5%) (adjusted hazard ratio, 1.34 (95% confidence interval, 1.22–1.47), p < 0.001) and those above-target (1.42 (1.29–1.57), p < 0.001). Risk was increased among individuals in the lowest HbA1c category (<6.5%) and those below-target only if treated with agents causing hypoglycaemia (1.16 (1.03–1.29), p = 0.01 and 1.10 (1.01–1.22), p = 0.04, respectively). These data suggest the importance of setting both upper and lower personalized HbA1c goals to avoid overtreatment in high-risk individuals with type 2 diabetes treated with agents causing hypoglycaemia.

scholarly journals The association of dialysis adequacy, body mass index, and mortality among hemodialysis patients

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Woong-pyo Hong ◽  
Yu-Ji Lee
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Mortality Risk ◽  
Cox Regression ◽  
Target Range ◽  
Dialysis Adequacy ◽  
Cox Regression Analysis ◽  
Increased Risk ◽  
All Cause Mortality ◽  
High Bmi

Abstract Background Although hemodialysis (HD) adequacy, single-pool Kt/Vurea (spKt/V), is inversely correlated with body size, each is known to affect patient survival in the same direction. Therefore, we sought to examine the relationship between HD adequacy and mortality according to body mass index (BMI) in HD patients and explore a combination effect of BMI and HD adequacy on mortality risk. Methods We retrospectively reviewed patient data from the Korean Society of Nephrology registry, a nationwide database of medical records of HD patients, from January 2001 to June 2017. We included patients ≥18 years old who were receiving maintenance HD. Patients were categorized into three groups according to baseline BMI (< 20 (low), 20 to < 23 (normal), and ≥ 23 (high) kg/m2). Baseline spKt/V was divided into six categories. Results Among 18,242 patients on HD, the median follow-up duration was 5.2 (IQR, 1.9–8.9) years. Cox regression analysis showed that, compared to the reference (spKt/V 1.2–1.4), lower and higher baseline spKt/V were associated with greater and lower risks for all-cause mortality, respectively. However, among patients with high BMI (n = 5588), the association between higher spKt/V and lower all-cause mortality was attenuated in all adjusted models (Pinteraction < 0.001). Compared to patients with normal BMI and spKt/V within the target range (1.2–1.4), those with low BMI had a higher risk for all-cause mortality at all spKt/V levels. However, the gap in mortality risk became narrower for higher values of spKt/V. Compared to patients with normal BMI and spKt/V in the target range, those with high BMI and spKt/V < 1.2 were not at increased risk for mortality despite low dialysis adequacy. Conclusions The association between spKt/V and mortality in HD patients may be modified by BMI.

scholarly journals Awaking Blood Pressure Surge and Progression to Microalbuminuria in Type 2 Normotensive Diabetic Patients

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Michelangela Barbieri ◽  
Maria Rosaria Rizzo ◽  
Ilaria Fava ◽  
Celestino Sardu ◽  
Nicola Angelico ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Cox Regression ◽  
Blood Pressure Monitoring ◽  
Adult Patients ◽  
Diabetic Patients ◽  
Increased Risk ◽  
Pressure Surge

Background. We investigated the predictive value of morning blood pressure surge (MBPS) on the development of microalbuminuria in normotensive adults with a recent diagnosis of type 2 diabetes.Methods. Prospective assessments of 24-hour ambulatory blood pressure monitoring and urinary albumin excretion were performed in 377 adult patients. Multivariate-adjusted Cox regression models were used to assess hazard ratios (HRs) between baseline and changes over follow-up in MBPS and the risk of microalbuminuria. The MBPS was calculated as follows: mean systolic BP during the 2 hours after awakening minus mean systolic BP during the 1 hour that included the lowest sleep BP.Results. After a mean follow-up of 6.5 years, microalbuminuria developed in 102 patients. An increase in MBPB during follow-up was associated with an increased risk of microalbuminuria. Compared to individuals in the lowest tertile (−0.67±1.10 mmHg), the HR and 95% CI for microalbuminuria in those in the highest tertile of change (24.86±6.92 mmHg) during follow-up were 17.41 (95% CI 6.26–48.42);pfor trend <0.001. Mean SD MBPS significantly increased in those who developed microalbuminuria from a mean [SD] of 10.6[1.4]to 36.8[7.1],p<0.001.Conclusion. An increase in MBPS is associated with the risk of microalbuminuria in normotensive adult patients with type 2 diabetes.

scholarly journals Body Mass Index: A Risk Factor for Retinopathy in Type 2 Diabetic Patients

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Snježana Kaštelan ◽  
Martina Tomić ◽  
Antonela Gverović Antunica ◽  
Spomenka Ljubić ◽  
Jasminka Salopek Rabatić ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Body Mass Index ◽  
Body Mass ◽  
Developed Countries ◽  
Diabetes Duration ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Significant Deterioration ◽  
Group 2

The aim of the study was to investigate whether body mass index (BMI) independently or in correlation with other risk factors is associated with diabetic retinopathy (DR) progression. The study included 545 patients with type 2 diabetes. According to DR status, they were divided into three groups: group 1 (no retinopathy;n=296), group 2 (mild/moderate nonproliferative DR;n=118), and group 3 (severe/very severe NPDR or proliferative DR;n=131). Patients without DR were younger than those with signs of retinopathy at time of diabetes onset whilst diabetes duration was longer in groups with severe NPDR and PDR. DR progression was correlated with diabetes duration, BMI, HbA1c, hypertension, and cholesterol. Statistical analyses showed that the progression of retinopathy increased significantly with higher BMI (gr. 1: 26.50 ± 2.70, gr. 2: 28.11 ± 3.00, gr. 3: 28.69 ± 2.50;P<0.01). We observed a significant deterioration of HbA1c and a significant increase in cholesterol and hypertension with an increase in BMI. Correlation between BMI and triglycerides was not significant. Thus, BMI in correlation with HbA1c cholesterol and hypertension appears to be associated with the progression of DR in type 2 diabetes and may serve as a predictive factor for the development of this important cause of visual loss in developed countries.

scholarly journals Association of BMI, comorbidities and all-cause mortality by using a baseline mortality risk model

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0253696
Author(s):  
Jia Li ◽  
Gyorgy Simon ◽  
M. Regina Castro ◽  
Vipin Kumar ◽  
Michael S. Steinbach ◽  
...  
Keyword(s):  
Body Mass ◽  
Mortality Risk ◽  
Risk Model ◽  
Risk Groups ◽  
Baseline Risk ◽  
Increased Risk ◽  
Wide Range ◽  
Baseline Mortality ◽  
All Cause Mortality

Objective The association of body mass index (BMI) and all-cause mortality is controversial, frequently referred to as a paradox. Whether the cause is metabolic factors or statistical biases is still controversial. We assessed the association of BMI and all-cause mortality considering a wide range of comorbidities and baseline mortality risk. Methods Retrospective cohort study of Olmsted County residents with at least one BMI measurement between 2000–2005, clinical data in the electronic health record and minimum 8 year follow-up or death within this time. The cohort was categorized based on baseline mortality risk: Low, Medium, Medium-high, High and Very-high. All-cause mortality was assessed for BMI intervals of 5 and 0.5 Kg/m2. Results Of 39,739 subjects (average age 52.6, range 18–89; 38.1% male) 11.86% died during 8-year follow-up. The 8-year all-cause mortality risk had a “U” shape with a flat nadir in all the risk groups. Extreme BMI showed higher risk (BMI <15 = 36.4%, 15 to <20 = 15.4% and ≥45 = 13.7%), while intermediate BMI categories showed a plateau between 10.6 and 12.5%. The increased risk attributed to baseline risk and comorbidities was more obvious than the risk based on BMI increase within the same risk groups. Conclusions There is a complex association between BMI and all-cause mortality when evaluated including comorbidities and baseline mortality risk. In general, comorbidities are better predictors of mortality risk except at extreme BMIs. In patients with no or few comorbidities, BMI seems to better define mortality risk. Aggressive management of comorbidities may provide better survival outcome for patients with body mass between normal and moderate obesity.

scholarly journals The study of correlation between Body Mass Index and glycemic control-HbA1c in diabetes type 2 patients

2019 ◽  
Vol 6 (6) ◽  
pp. 1788
Author(s):  
Rakesh K. Sisodia ◽  
Mahendra Chouhan
Keyword(s):  
Body Mass Index ◽  
Glycaemic Control ◽  
Body Mass ◽  
Normal Weight ◽  
Diabetic Patients ◽  
Poor Glycaemic Control ◽  
Risk Of Death ◽  
Increased Risk ◽  
Type 2 Diabetic

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.

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