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J Obes Metab Syndr. 2018 Mar;27(1):61-70. English. Original Article. https://doi.org/10.7570/jomes.2018.27.1.61
Lee DH , Ha KH , Kim HC , Kim DJ .
Ajou University School of Medicine, Suwon, Korea.
Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea. djkim@ajou.ac.kr
Cardiovascular and Metabolic Disease Etiology Research Center, Ajou University School of Medicine, Suwon, Korea.
Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.
Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea.
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.

Copyright © 2019. Korean Association of Medical Journal Editors.