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.
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/obeseparticipants (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/obeseparticipants 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.
Authors: Wolfram Doehner; Erland Erdmann; Richard Cairns; Andrew L Clark; John A Dormandy; Ele Ferrannini; Stefan D Anker Journal: Int J Cardiol Date: 2011-10-29 Impact factor: 4.164
Authors: John R B Perry; Benjamin F Voight; Loïc Yengo; Najaf Amin; Josée Dupuis; Martha Ganser; Harald Grallert; Pau Navarro; Man Li; Lu Qi; Valgerdur Steinthorsdottir; Robert A Scott; Peter Almgren; Dan E Arking; Yurii Aulchenko; Beverley Balkau; Rafn Benediktsson; Richard N Bergman; Eric Boerwinkle; Lori Bonnycastle; Noël P Burtt; Harry Campbell; Guillaume Charpentier; Francis S Collins; Christian Gieger; Todd Green; Samy Hadjadj; Andrew T Hattersley; Christian Herder; Albert Hofman; Andrew D Johnson; Anna Kottgen; Peter Kraft; Yann Labrune; Claudia Langenberg; Alisa K Manning; Karen L Mohlke; Andrew P Morris; Ben Oostra; James Pankow; Ann-Kristin Petersen; Peter P Pramstaller; Inga Prokopenko; Wolfgang Rathmann; William Rayner; Michael Roden; Igor Rudan; Denis Rybin; Laura J Scott; Gunnar Sigurdsson; Rob Sladek; Gudmar Thorleifsson; Unnur Thorsteinsdottir; Jaakko Tuomilehto; Andre G Uitterlinden; Sidonie Vivequin; Michael N Weedon; Alan F Wright; Frank B Hu; Thomas Illig; Linda Kao; James B Meigs; James F Wilson; Kari Stefansson; Cornelia van Duijn; David Altschuler; Andrew D Morris; Michael Boehnke; Mark I McCarthy; Philippe Froguel; Colin N A Palmer; Nicholas J Wareham; Leif Groop; Timothy M Frayling; Stéphane Cauchi Journal: PLoS Genet Date: 2012-05-31 Impact factor: 5.917
Authors: Richard M Bergenstal; Mary Johnson; Rebecca Passi; Anuj Bhargava; Natalie Young; Davida F Kruger; Eran Bashan; Stanley G Bisgaier; Deanna J Marriott Isaman; Israel Hodish Journal: Lancet Date: 2019-02-23 Impact factor: 79.321
Authors: Alan S Go; Dariush Mozaffarian; Véronique L Roger; Emelia J Benjamin; Jarett D Berry; Michael J Blaha; Shifan Dai; Earl S Ford; Caroline S Fox; Sheila Franco; Heather J Fullerton; Cathleen Gillespie; Susan M Hailpern; John A Heit; Virginia J Howard; Mark D Huffman; Suzanne E Judd; Brett M Kissela; Steven J Kittner; Daniel T Lackland; Judith H Lichtman; Lynda D Lisabeth; Rachel H Mackey; David J Magid; Gregory M Marcus; Ariane Marelli; David B Matchar; Darren K McGuire; Emile R Mohler; Claudia S Moy; Michael E Mussolino; Robert W Neumar; Graham Nichol; Dilip K Pandey; Nina P Paynter; Matthew J Reeves; Paul D Sorlie; Joel Stein; Amytis Towfighi; Tanya N Turan; Salim S Virani; Nathan D Wong; Daniel Woo; Melanie B Turner Journal: Circulation Date: 2013-12-18 Impact factor: 29.690