Baseline and longitudinal trajectories of body-mass index and all-cause mortality among patients with type 2 diabetes

IF 4.6 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Diabetes & metabolism Pub Date : 2023-05-01 DOI:10.1016/j.diabet.2023.101426
Zongming Yang , Peng Shen , Yanlin Qu , Lisha Xu , Tiezheng Li , Zhanghang Zhu , Yonghao Wu , Luhua Yu , Kai Gao , Xinhan Zhang , Xuecheng Yao , Lin Meng , Hongbo Lin , Liming Shui , Mengling Tang , Mingjuan Jin , Kun Chen , Jianbing Wang
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引用次数: 1

Abstract

Aim

To investigate the associations of baseline body mass index (BMI) and longitudinal BMI trajectories with all-cause mortality among patients with type 2 diabetes mellitus (T2DM).

Methods,

We used data from the diabetes surveillance system of Yinzhou Health Information System with T2DM patients registered from 2010 to 2015. Participants aged ≥ 40 years were included and were followed up until September 30, 2021. The latent class growth mixture model was used to identify different changing patterns in BMI for 5 years from registration. Cox proportional hazards models were used to examine the associations of baseline BMI and 5-year BMI trajectories with all-cause mortality.

Results

We observed a nonlinear association between baseline BMI and all-cause mortality (P for nonlinearity < 0.001), with an increased risk of death for low but not high BMI. However, compared with participants with medium-stable BMI for 5 years from baseline, individuals with increasing BMI had higher mortality, with adjusted hazard ratios (95% confidence intervals) 1.21 (1.02;1.43) for early-increasing and 1.47 (1.19;1.80) for late-sharp increasing groups.

Conclusion

These findings suggest that while obesity itself may not be associated with an increased risk for mortality, weight gain, and in particular rapid weight gain, is a risk factor for mortality among patients with T2DM.

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2型糖尿病患者身体质量指数和全因死亡率的基线和纵向轨迹
目的探讨2型糖尿病(T2DM)患者基线体重指数(BMI)和纵向BMI轨迹与全因死亡率的关系。年龄≥40岁的参与者被纳入其中,并被随访至2021年9月30日。潜在类别增长混合模型用于识别注册后5年内BMI的不同变化模式。Cox比例风险模型用于检验基线BMI和5年BMI轨迹与全因死亡率的相关性。结果我们观察到基线BMI与全因死亡率之间存在非线性关系(非线性<0.001的P),低但不高的BMI会增加死亡风险。然而,与基线后5年BMI中等稳定的参与者相比,BMI增加的个体死亡率更高,早期增加组的调整后风险比(95%置信区间)为1.21(1.02;1.43),晚期急剧增加组为1.47(1.19;1.80)。结论这些发现表明,虽然肥胖本身可能与死亡率增加无关,但体重增加,特别是快速体重增加,是T2DM患者死亡率的一个危险因素。
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来源期刊
Diabetes & metabolism
Diabetes & metabolism 医学-内分泌学与代谢
CiteScore
12.00
自引率
4.20%
发文量
86
审稿时长
13 days
期刊介绍: A high quality scientific journal with an international readership Official publication of the SFD, Diabetes & Metabolism, publishes high-quality papers by leading teams, forming a close link between hospital and research units. Diabetes & Metabolism is published in English language and is indexed in all major databases with its impact factor constantly progressing. Diabetes & Metabolism contains original articles, short reports and comprehensive reviews.
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