Association of weight status with mortality in adults with incident diabetes.

Pubmed ID: 22871870

Pubmed Central ID: PMC3467944

Journal: JAMA

Publication Date: Aug. 8, 2012

MeSH Terms: Humans, Male, Adult, Female, Aged, Aged, 80 and over, Cardiovascular Diseases, United States, Middle Aged, Longitudinal Studies, Body Mass Index, Cause of Death, Obesity, Overweight, Body Weight, Diabetes Mellitus, Type 2

Grants: 5 R01 HL078972, AG-023629, AG-027058, AG-20098, HL080295, N01 HC-55222, N01-HC-48047, N01-HC-48048, N01-HC-48049, N01-HC-48050, N01-HC-55015, N01-HC-55016, N01-HC-55018, N01-HC-55019, N01-HC-55020, N01-HC-55021, N01-HC-55022, N01-HC-75150, N01-HC-85079, N01-HC-85080, N01-HC-85081, N01-HC-85082, N01-HC-85083, N01-HC-85084, N01-HC-85085, N01-HC-85086, N01-HC-85239, N01-HC-95095, N01-HC-95159, N01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC-95164, N01-HC-95165, N01-HC-95169, R21 DK082903, R21DK082903, N01 HC015103, N01 HC035129, N01 HC045133, N01HC55222, N01HC75150, N01HC85079, N01HC85086, R01 AG015928, R01 AG020098, R01 AG023629, R01 AG027058, R01 HL080295, U01 HL080295, R56 AG023629, P30 DK079637, N01HC95159, N01HC95169, N01HC95165, N01HC55020, N01HC55018, R01 HL078972, N01HC48049, R56 AG020098, N01HC55022, N01HC55015, N01HC95095, N01HC55016, N01HC48050, N01HC55019, N01HC48047, N01HC55021, N01HC48048

Authors: Mukamal KJ, Carnethon MR, De Chavez PJ, Biggs ML, Lewis CE, Pankow JS, Bertoni AG, Golden SH, Liu K, Campbell-Jenkins B, Dyer AR

Cite As: Carnethon MR, De Chavez PJ, Biggs ML, Lewis CE, Pankow JS, Bertoni AG, Golden SH, Liu K, Mukamal KJ, Campbell-Jenkins B, Dyer AR. Association of weight status with mortality in adults with incident diabetes. JAMA 2012 Aug 8;308(6):581-90.

Studies:

Abstract

CONTEXT: Type 2 diabetes in normal-weight adults (body mass index [BMI] <25) is a representation of the metabolically obese normal-weight phenotype with unknown mortality consequences. OBJECTIVE: To test the association of weight status with mortality in adults with new-onset diabetes in order to minimize the influence of diabetes duration and voluntary weight loss on mortality. DESIGN, SETTING, AND PARTICIPANTS: Pooled analysis of 5 longitudinal cohort studies: Atherosclerosis Risk in Communities study, 1990-2006; Cardiovascular Health Study, 1992-2008; Coronary Artery Risk Development in Young Adults, 1987-2011; Framingham Offspring Study, 1979-2007; and Multi-Ethnic Study of Atherosclerosis, 2002-2011. A total of 2625 participants with incident diabetes contributed 27,125 person-years of follow-up. Included were men and women (age >40 years) who developed incident diabetes based on fasting glucose 126 mg/dL or greater or newly initiated diabetes medication and who had concurrent measurements of BMI. Participants were classified as normal weight if their BMI was 18.5 to 24.99 or overweight/obese if BMI was 25 or greater. MAIN OUTCOME MEASURES: Total, cardiovascular, and noncardiovascular mortality. RESULTS: The proportion of adults who were normal weight at the time of incident diabetes ranged from 9% to 21% (overall 12%). During follow-up, 449 participants died: 178 from cardiovascular causes and 253 from noncardiovascular causes (18 were not classified). The rates of total, cardiovascular, and noncardiovascular mortality were higher in normal-weight participants (284.8, 99.8, and 198.1 per 10,000 person-years, respectively) than in overweight/obese participants (152.1, 67.8, and 87.9 per 10,000 person-years, respectively). After adjustment for demographic characteristics and blood pressure, lipid levels, waist circumference, and smoking status, hazard ratios comparing normal-weight participants with overweight/obese participants for total, cardiovascular, and noncardiovascular mortality were 2.08 (95% CI, 1.52-2.85), 1.52 (95% CI, 0.89-2.58), and 2.32 (95% CI, 1.55-3.48), respectively. CONCLUSION: Adults who were normal weight at the time of incident diabetes had higher mortality than adults who are overweight or obese.