Dataset Information

Obesity and Life Expectancy with and without Diabetes in Adults Aged 55 Years and Older in the Netherlands: A Prospective Cohort Study.

ABSTRACT: Overweight and obesity are associated with increased risk of type 2 diabetes. Limited evidence exists regarding the effect of excess weight on years lived with and without diabetes. We aimed to determine the association of overweight and obesity with the number of years lived with and without diabetes in a middle-aged and elderly population.The study included 6,499 individuals (3,656 women) aged 55 y and older from the population-based Rotterdam Study. We developed a multistate life table to calculate life expectancy for individuals who were normal weight, overweight, and obese and the difference in years lived with and without diabetes. For life table calculations, we used prevalence, incidence rate, and hazard ratios (HRs) for three transitions (healthy to diabetes, healthy to death, and diabetes to death), stratifying by body mass index (BMI) at baseline and adjusting for confounders. During a median follow-up of 11.1 y, we observed 697 incident diabetes events and 2,192 overall deaths. Obesity was associated with an increased risk of developing diabetes (HR: 2.13 [p < 0.001] for men and 3.54 [p < 0.001] for women). Overweight and obesity were not associated with mortality in men and women with or without diabetes. Total life expectancy remained unaffected by overweight and obesity. Nevertheless, men with obesity aged 55 y and older lived 2.8 (95% CI -6.1 to -0.1) fewer y without diabetes than normal weight individuals, whereas, for women, the difference between obese and normal weight counterparts was 4.7 (95% CI -9.0 to -0.6) y. Men and women with obesity lived 2.8 (95% CI 0.6 to 6.2) and 5.3 (95% CI 1.6 to 9.3) y longer with diabetes, respectively, compared to their normal weight counterparts. Since the implications of these findings could be limited to middle-aged and older white European populations, our results need confirmation in other populations.Obesity in the middle aged and elderly is associated with a reduction in the number of years lived free of diabetes and an increase in the number of years lived with diabetes. Those extra years lived with morbidity might place a high toll on individuals and health care systems.

SUBMITTER: Dhana K

PROVIDER: S-EPMC4951120 | biostudies-literature | 2016 Jul

REPOSITORIES: biostudies-literature

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Obesity and Life Expectancy with and without Diabetes in Adults Aged 55 Years and Older in the Netherlands: A Prospective Cohort Study.

Dhana Klodian K Nano Jana J Ligthart Symen S Peeters Anna A Hofman Albert A Nusselder Wilma W Dehghan Abbas A Franco Oscar H OH

PLoS medicine 20160719 7

<h4>Background</h4>Overweight and obesity are associated with increased risk of type 2 diabetes. Limited evidence exists regarding the effect of excess weight on years lived with and without diabetes. We aimed to determine the association of overweight and obesity with the number of years lived with and without diabetes in a middle-aged and elderly population.<h4>Methods and findings</h4>The study included 6,499 individuals (3,656 women) aged 55 y and older from the population-based Rotterdam St ...[more]

PMID: 27433939

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Project description:IntroductionMultimorbid chronic diseases are usually considered separately in trials. Here, we aimed to describe overall multimorbidity patterns in adults aged 55 years or older and assess their effect on health-related quality of life (HRQoL).MethodsWe used data for 5,647 participants included in the SUpplémentation en VItamines et Minéraux AntioXydants 2 (SU.VI.MAX 2) population-based trial. HRQoL was assessed by the French versions of the Medical Outcome Study Short Form 36 and the Duke Health Profile. An exploratory factor analysis was used to determine multimorbidity patterns, and a multimorbidity score for each resulting pattern was calculated. Adjusted multiple linear regression was used to examine the association between the identified multimorbidity and HRQoL scores by gender and for each age group (55-59, 60-64, 65-69, ? 70 years).ResultsMore than 63% of the sample reported two or more chronic conditions (from 55.8% for those 55-59 years to 74.4% for those ? 70 years). Multimorbidity was more common among women than men (67.3% vs 60%). Two different multimorbidity patterns were identified. Pattern A was represented mainly by mental illness and bone impairments. Pattern B was represented mainly by cardiovascular and metabolic disorders. After adjusting for covariates, a high pattern A score was associated with reduced HRQoL for the physical and mental components of each HRQoL questionnaire, and a high pattern B score was associated with reduced HRQoL for only the physical component of each questionnaire. These multimorbidity scores affected HRQoL differently by age group.ConclusionOur study used a novel methodological approach to account for multimorbidity patterns in determining the link with chronic conditions. These multimorbidity scores (counted and weighted) can be used in clinical research to control for the effect of multimorbidity on patients' HRQoL and may be useful for clinical practice.Clinical trial registrationClinicaltrial.gov (number NCT00272428).

Project description:Obesity increases the risk of heart failure and atrial fibrillation. Left atrial (LA) dysfunction is increasingly recognized as a mediator of cardiovascular disease. Early effects of obesity on LA function have not been examined in large population samples. We quantified LA strain and strain rate (SR) through speckle tracking echocardiography in 1,531 middle-aged community-based participants enrolled in the Asklepios study. We compared LA function between individuals with body mass index (BMI) < 25 kg/m2 (n?=?779), 25 to 29.9 kg/m2 (n?=?618) and ? 30 kg/m2 (n?=?134). Significant differences in reservoir longitudinal LA strain (BMI < 25 kg/m2?=?35.3%, BMI 25-29.9 kg/m2?=?33.1%, and BMI ? 30 kg/m2?=?30.9%; p < 0.00001) strain rate ([SR] BMI < 25 kg/m2?=?151; BMI 25 to 29.9 kg/m2?=?141; and BMI ? 30 kg/m2?=?135 %/s; p <0.00001) and expansion index (BMI < 25 kg/m2?=?1.6, BMI 25 to 29.9 kg/m2?=?1.4, and BMI ? 30 kg/m2?=?1.4; p <0.00001) were seen, indicating reduced reservoir function with increasing BMI. Obesity was also associated with impaired LA conduit function, including conduit longitudinal LA strain (BMI < 25 kg/m2?=?21.6%, BMI 25 to 29.9 kg/m2?=?18.9%, and BMI ? 30 kg/m2?=?16.7%; p <0.00001), SR (BMI < 25 kg/m2?=?-189, BMI 25 to 29.9 kg/m2?=?166, and BMI ? 30 kg/m2?=?150 %/s; p <0.0001) and passive LA emptying fraction (BMI < 25 kg/m2?=?40.5, BMI 25 to 29.9 kg/m2?=?36.5, and BMI ? 30 kg/m2?=?36%, p <0.00001). These differences persisted after adjustment for age, gender and other potential confounders. In contrast to reservoir and conduit function, obesity was associated with increased booster pump function (active LA emptying fraction: BMI < 25 kg/m2?=?19.4%, BMI 25 to 29.9 kg/m2?=?20.5%, and BMI ? 30 kg/m2?=?21.5%; p <0.00001). In middle-aged adults, obesity is associated with impaired reservoir and conduit LA function and higher booster function, which may be compensatory. Loss of booster LA function, either because of more advanced LA dysfunction or atrial fibrillation, may play an important role in precipitating heart failure in obese individuals.

Dataset Information

Obesity and Life Expectancy with and without Diabetes in Adults Aged 55 Years and Older in the Netherlands: A Prospective Cohort Study.

Publications

Obesity and Life Expectancy with and without Diabetes in Adults Aged 55 Years and Older in the Netherlands: A Prospective Cohort Study.

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