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

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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:BackgroundPrevious studies reported the prognostic value of the atherogenic index of plasma (AIP) in the course of atherosclerosis and other cardiovascular diseases (CVDs). Still, the predictive utility of the AIP is unknown among patients with type 2 diabetes mellitus (T2DM).MethodsThis was a secondary analysis of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study, which randomized 10,251 patients with long-lasting T2DM. ROC curve analysis was used to determine an optimal threshold for AIP, and the study population was divided into high and low AIP groups. Univariable and multivariable Cox proportional hazards regression analyses were used to determine the association between AIP and primary (major adverse cardiovascular events [MACEs], including nonfatal myocardial infarction, nonfatal stroke, and/or death from cardiovascular causes) and secondary outcomes (all-cause mortality). Stratified analyses were performed to control for the confounding factors.ResultsAIP was an independent risk factor for the prognosis of T2DM (HR = 1.309; 95% CI 1.084-1.581; P = 0.005). The threshold for AIP was determined to be 0.34 in the study population. After adjustments for confounding factors, multivariable analysis showed that AIP was associated with the risk of MACEs (Model 1: HR = 1.333, 95% CI 1.205-1.474, P < 0.001; Model 2: HR = 1.171, 95% CI 1.030-1.333, P = 0.016; Model 3: HR = 1.194, 95% CI 1.049-1.360, P = 0.007), all-cause mortality (Model 1: HR = 1.184, 95% CI 1.077-1.303, P < 0.001), cardiovascular death (Model 1: HR = 1.422, 95% CI 1.201-1.683, P < 0.001; Model 3: HR = 1.264, 95% CI 1.015-1.573, P = 0.036), and nonfatal myocardial infarction (Model 1: HR = 1.447, 95% CI 1.255-1.669, P < 0.001; Model 2: HR = 1.252, 95% CI 1.045-1.499, P = 0.015; Model 3: HR = 1.284, 95% CI 1.071-1.539, P = 0.007). Subgroup stratified analyses showed that AIP might interact with sex, a classical risk factor of cardiovascular events.ConclusionsThis study showed that AIP might be a strong biomarker that could be used to predict the risk of cardiovascular events in patients with T2DM.Trial registrationURL: http://www.clinicaltrials.gov . Unique identifier: NCT00000620.

Project description:BackgroundCardiovascular disease accounts for about one-third of all premature deaths (ie, age < 70) in Cuba. Yet, the relevance of major risk factors, including systolic blood pressure (SBP), diabetes, and body-mass index (BMI), to cardiovascular mortality in this population remains unclear.MethodsIn 1996-2002, 146,556 adults were recruited from the general population in five areas of Cuba. Participants were interviewed, measured (height, weight and blood pressure) and followed up by electronic linkage to national death registries until Jan 1, 2017; in 2006-08, 24,345 participants were resurveyed. After excluding all with missing data, cardiovascular disease at recruitment, and those who died in the first 5 years, Cox regression (adjusted for age, sex, education, smoking, alcohol and, where appropriate, BMI) was used to relate cardiovascular mortality rate ratios (RRs) at ages 35-79 years to SBP, diabetes and BMI; RR were corrected for regression dilution to give associations with long-term average (ie, 'usual') levels of SBP and BMI.ResultsAfter exclusions, there were 125,939 participants (mean age 53 [SD12]; 55% women). Mean SBP was 124 mmHg (SD15), 5% had diabetes, and mean BMI was 24.2 kg/m2 (SD3.6); mean SBP and diabetes prevalence at recruitment were both strongly related to BMI. During follow-up, there were 4112 cardiovascular deaths (2032 ischaemic heart disease, 832 stroke, and 1248 other). Cardiovascular mortality was positively associated with SBP (>=120 mmHg), diabetes, and BMI (>=22.5 kg/m2): 20 mmHg higher usual SBP about doubled cardiovascular mortality (RR 2.02, 95%CI 1.88-2.18]), as did diabetes (2.15, 1.95-2.37), and 10 kg/m2 higher usual BMI (1.92, 1.64-2.25). RR were similar in men and in women. The association with BMI and cardiovascular mortality was almost completely attenuated following adjustment for the mediating effect of SBP. Elevated SBP (>=120 mmHg), diabetes and raised BMI (>=22.5 kg/m2) accounted for 27%, 14%, and 16% of cardiovascular deaths, respectively.ConclusionsThis large prospective study provides direct evidence for the effects of these major risk factors on cardiovascular mortality in Cuba. Despite comparatively low levels of these risk factors by international standards, the strength of their association with cardiovascular death means they nevertheless exert a substantial impact on premature mortality in Cuba.

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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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