Kwon, Yeongkeun; Kim, Hyun Jung; Park, Sungsoo; Park, Yong-Gyu; Cho, Kyung-Hwan
PloS one
2017NA ; 12 ( 1 ) :e0168247.
PMID : 28046128
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Kwon, Yeongkeun -
Kim, Hyun Jung -
Park, Sungsoo -
Park, Yong-Gyu -
Cho, Kyung-Hwan -
ABSTRACT
OBJECTIVE: We conducted a systematic review and meta-analysis of studies to quantify the association between body mass index (BMI) and the risks of all-cause and cardiovascular mortality in patients with type 2 diabetes.
METHODS: We included studies assessing the impact of BMI on all-cause and cardiovascular mortality in patients with type 2 diabetes. Data were combined using a random-effects dose-response model.
RESULTS: Sixteen cohort studies on all-cause mortality (n = 445,125) and two studies on cardiovascular mortality (n = 92,841) were evaluated in the meta-analysis. A non-linear association was observed between BMI and all-cause mortality among patients with type 2 diabetes. With a BMI nadir of 28-30 kg/m2, the risk of all-cause mortality displayed a U-shaped increase. With a BMI nadir of 29-31 kg/m2, the risk of cardiovascular mortality exhibited a gradual non-linear increase for BMI > 31 kg/m2. Subgroup analyses suggested that study location, diabetes duration, and smoking history may have contributed to heterogeneity among the studies.
CONCLUSIONS: An obesity paradox exists for patients with type 2 diabetes with respect to all-cause and cardiovascular mortality. Study location, diabetes duration, and smoking history might contribute to heterogeneity among obesity paradox studies of patients with type 2 diabetes.
Aged; Algorithms; *Body Mass Index; Cardiovascular Diseases/etiology; Cause of Death; Cohort Studies; Diabetes Mellitus, Type 2/complications/*mortality; Female; Humans; Male; Middle Aged; Models, Statistical; Obesity/complications/*mortality; Quality Assurance, Health Care; Research Design; Risk Factors
MESH
Aged, Algorithms, *Body Mass Index, Cardiovascular Diseases/etiology, Cause of Death, Cohort Studies, Diabetes Mellitus, Type 2/complications/*mortality, Female, Humans, Male, Middle Aged, Models, Statistical, Obesity/complications/*mortality, Quality Assurance, Health Care, Research Design, Risk Factors
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