Dataset Information

Association of Body Mass Index with Risk of Major Adverse Cardiovascular Events and Mortality in People with Diabetes.

ABSTRACT:

Background

The relationship between cardiovascular and all-cause mortality and obesity in people with diabetes is still controversial. We investigated the association of body mass index (BMI) with the risk of major adverse cardiovascular events (MACE) and all-cause mortality in people with diabetes.

Methods

In total, 48,438 people with diabetes were enrolled in the Korean National Health Insurance Service-National Health Screening Cohort from 2002 to 2003 and were followed until 2013. Baseline BMI was categorized as underweight (<18.5 kg/m²), normal-weight (18.5-22.9 kg/m²), overweight (23.0-24.9 kg/m²), obese class I (25.0-29.9 kg/m²), and obese class II (?30.0 kg/m²).

Results

During a median of 10.7 years of follow-up (interquartile range, 10.2-11.2 years), there were 7,360 MACE and 5,766 deaths. Compared to those in the normal-weight group, the fully adjusted hazard ratios (HRs) for MACE were 1.09 (95% confidence interval [CI], 0.92-1.29), 0.91 (95% CI, 0.85-0.97), 0.93 (95% CI, 0.88-0.98), and 0.95 (95% CI, 0.84-1.06) for underweight, overweight, obese class I, and obese class II groups, respectively. The HRs for all-cause mortality were 1.75 (95% CI, 1.54-1.99), 0.74 (95% CI, 0.69-0.79), 0.67 (95% CI, 0.63-0.71), and 0.73 (95% CI, 0.63-0.85) for underweight, overweight, obese class I, and obese class II groups, respectively.

Conclusion

In people with diabetes, underweight people had a higher risk for all-cause mortality, whereas overweight or obese people had a lower risk for MACE and all-cause mortality than those with a normal weight.

SUBMITTER: Lee DH

PROVIDER: S-EPMC6489483 | biostudies-literature | 2018 Mar

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Association of Body Mass Index with Risk of Major Adverse Cardiovascular Events and Mortality in People with Diabetes.

Lee Dong Hun DH Ha Kyoung Hwa KH Kim Hyeon Chang HC Kim Dae Jung DJ

Journal of obesity & metabolic syndrome 20180301 1

<h4>Background</h4>The relationship between cardiovascular and all-cause mortality and obesity in people with diabetes is still controversial. We investigated the association of body mass index (BMI) with the risk of major adverse cardiovascular events (MACE) and all-cause mortality in people with diabetes.<h4>Methods</h4>In total, 48,438 people with diabetes were enrolled in the Korean National Health Insurance Service-National Health Screening Cohort from 2002 to 2003 and were followed until 2 ...[more]

PMID: 31089542

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Project description:BackgroundThe triglyceride-glucose (TyG) index is a reliable surrogate marker of insulin resistance and is associated with major adverse cardiovascular events (MACEs) in patients with type 2 diabetes mellitus (T2DM). However, the long-term effect of the TyG index on the incidence of MACEs remains unclear. We aimed to investigate the association between the cumulative TyG index and the risk of MACEs in patients with T2DM.MethodsThis post-hoc analysis of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial assessed patients' (T2DM > 3 months) cumulative TyG index and MACE data from the study database. Five fasting blood glucose and triglyceride measurements, at baseline and the first four visits, were taken from 5695 participants who had not experienced MACEs. Cumulative exposure to the TyG index was calculated as the weighted sum of the mean TyG index value for each time interval (value × time). Multivariable-adjusted Cox proportional hazard models and restricted cubic spline analysis were used to determine the association between the cumulative TyG index and MACEs. The incremental predictive value of the cumulative TyG index was further assessed.ResultsOver a median follow-up of 5.09 years, 673 (11.82%) MACEs occurred, including 256 (4.50%) cardiovascular disease (CVD) deaths, 288 (5.06%) non-fatal myocardial infarctions (MIs), and 197 (3.46%) strokes. The risk of developing MACEs increased with the cumulative TyG index quartile. After adjusting for multiple potential confounders, the hazard ratios for the very high cumulative TyG index group versus the low group were 1.59 (95% confidence interval [CI], 1.17-2.16), 1.97 (95% CI 1.19-3.26), and 1.66 (95% CI 1.02-2.70) for overall MACEs, CVD death, and non-fatal MI, respectively. Restricted cubic spline analysis also showed a cumulative increase in the risk of MACEs with an increase in the magnitude of the cumulative TyG index. The addition of the cumulative TyG index to a conventional risk model for MACEs improved the C-statistics, net reclassification improvement value, and integrated discrimination improvement value.ConclusionsIn patients with T2DM, the cumulative TyG index independently predicts the incidence of MACEs, and monitoring the long-term TyG index may assist with optimized-for-risk stratification and outcome prediction for MACEs. Trial registration URL: http://www.Clinicaltrialsgov . Unique identifier: NCT00000620.

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Dataset Information

Association of Body Mass Index with Risk of Major Adverse Cardiovascular Events and Mortality in People with Diabetes.

Background

Methods

Results

Conclusion

Publications

Association of Body Mass Index with Risk of Major Adverse Cardiovascular Events and Mortality in People with Diabetes.

Similar Datasets

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