Endocrinol Metab.  2015 Dec;30(4):514-521. 10.3803/EnM.2015.30.4.514.

Characterization of Patients with Type 2 Diabetes according to Body Mass Index: Korea National Health and Nutrition Examination Survey from 2007 to 2011

• Lee DH
• Jung KY
• Park KS
• Kim KM
• Moon JH
• Lim S
• Jang HC
• Choi SH

• KMID: 2169661
• DOI: http://doi.org/10.3803/EnM.2015.30.4.514

Abstract

BACKGROUND
The present study aimed to investigate the clinical characteristics of type 2 diabetes mellitus (T2DM) in Korean adults according to body mass index (BMI) and to analyze the association with cardiovascular disease (CVD).
METHODS
We conducted a cross-sectional study of data from the Korea National Health and Nutrition Examination Survey from 2007 to 2011. A total of 3,370 patients with T2DM were divided into categories according to BMI. We conducted a comparison of the T2DM patient population composition by BMI category between different countries. We investigated the prevalence of awareness, treatment, and target control of T2DM according to BMI.
RESULTS
Patients with T2DM had a higher BMI, and were more likely to have a history of CVD than healthy controls. For Korean adults with T2DM, 8% had BMI > or =30 kg/m2. By contrast, the population of patients with T2DM and BMI > or =30 kg/m2 was 72% in patients in the USA and 56% in the UK. The rate of recognition, treatment, and control has worsened in parallel with increasing BMI. Even in patients with BMI 25 to 29.9 kg/m2, the prevalence of CVD or high risk factors for CVD was significantly higher than in patients with BMI 18.5 to 22.9 kg/m2 (odds ratio, 2.07).
CONCLUSION
Korean patients with T2DM had lower BMI than those in Western countries. Higher BMI was associated with lower awareness, treatment, and control of diabetes, and a positive association was observed between CVD or high risk factors for CVD and BMI, even for patients who were overweight but not obese.

Keyword

Diabetes mellitus, type 2; Body mass index; Cardiovascular diseases

MeSH Terms

Adult
Body Mass Index*
Cardiovascular Diseases
Cross-Sectional Studies
Diabetes Mellitus, Type 2
Humans
Korea*
Nutrition Surveys*
Overweight
Prevalence
Risk Factors

Figure

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  Fig. 1 Study population flow diagram. KNHANES, Korea National Health and Nutrition Examination Survey; HbA1c, hemoglobin A1c; BMI, body mass index; SBP, systolic blood pressure.

• 

  Fig. 2 Distribution of the body mass index (BMI) in type 2 diabetes according to country. aData were adopted from reference [11]; bData were adopted from reference [17]; cData were adopted from reference [4].

• 

  Fig. 3 Odds ratio (OR) of prevalence of cardiovascular disease (stroke, myocardial infarction [MI], or angina) or high risk factors for cardiovascular disease (hypertension, dyslipidemia) according to body mass index (BMI) categories. BMI of 18.5 to 22.9 kg/m2 as reference group. Using composite endpoint: stroke, MI or angina, hypertension, and dyslipidemia. Adjusted by age and smoking. CI, confidence interval.

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