Katarina Eeg-Olofsson1, Soffia Gudbjörnsdottir2, Björn Eliasson2, Björn Zethelius3, Jan Cederholm4. 1. Department of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden. Electronic address: katarina.eeg-olofsson@vgregion.se. 2. Department of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden. 3. Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, and Medical Products Agency, Uppsala, Sweden. 4. Department of Public Health and Caring Sciences/Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden.
Abstract
AIMS: Assessing the association between BMI and risk of coronary heart disease (CHD), cardiovascular disease (CVD) and mortality in patients with type 2 diabetes, also with regard to higher or lower levels of the ratio triglycerides-to-HDL-cholesterol (TG:HDL). METHODS: 54,061 patients with BMI≥18.5kg/m(2), mean age and duration 61.5±8 and 6.9±6 years, 59% males, 14% with CVD history, from the Swedish National Diabetes Register, followed for mean 4.8 years. RESULTS: Adjusting at Cox regression for non-BMI-linked (age, sex, smoking, CVD history) and BMI-linked (blood lipids, blood pressure, HbA1c, albuminuria) covariates, hazard ratios (HR) for fatal/nonfatal CHD and CVD were mainly increased with prominent obesity (BMI≥35kg/m(2)), 1.19 (p=0.01) and 1.17 (p=0.009), compared to normal weight (BMI 18.5-24.9kg/m(2)), although increased also with obesity (BMI 30-34.9kg/m(2)), 1.34 and 1.30 (p<0.001), when adjusting only for non-BMI-linked covariates. Stratifying by 75th percentile of TG:HDL, with normal weight and TG:HDL<1.9 as reference, obese and prominently obese with TG:HDL≥1.9 had considerably increased HR around 1.7 for fatal/nonfatal CHD and 1.6 for CVD (p<0.001), while obese and prominently obese with TG:HDL<1.9 only had HR 1.2-1.3 for CHD and CVD (p0.003-<0.01). CONCLUSION: Obese T2D patients with high TG:HDL, associated with increased insulin resistance, had considerably increased risk of CHD and CVD.
AIMS: Assessing the association between BMI and risk of coronary heart disease (CHD), cardiovascular disease (CVD) and mortality in patients with type 2 diabetes, also with regard to higher or lower levels of the ratio triglycerides-to-HDL-cholesterol (TG:HDL). METHODS: 54,061 patients with BMI≥18.5kg/m(2), mean age and duration 61.5±8 and 6.9±6 years, 59% males, 14% with CVD history, from the Swedish National Diabetes Register, followed for mean 4.8 years. RESULTS: Adjusting at Cox regression for non-BMI-linked (age, sex, smoking, CVD history) and BMI-linked (blood lipids, blood pressure, HbA1c, albuminuria) covariates, hazard ratios (HR) for fatal/nonfatal CHD and CVD were mainly increased with prominent obesity (BMI≥35kg/m(2)), 1.19 (p=0.01) and 1.17 (p=0.009), compared to normal weight (BMI 18.5-24.9kg/m(2)), although increased also with obesity (BMI 30-34.9kg/m(2)), 1.34 and 1.30 (p<0.001), when adjusting only for non-BMI-linked covariates. Stratifying by 75th percentile of TG:HDL, with normal weight and TG:HDL<1.9 as reference, obese and prominently obese with TG:HDL≥1.9 had considerably increased HR around 1.7 for fatal/nonfatal CHD and 1.6 for CVD (p<0.001), while obese and prominently obese with TG:HDL<1.9 only had HR 1.2-1.3 for CHD and CVD (p0.003-<0.01). CONCLUSION:Obese T2D patients with high TG:HDL, associated with increased insulin resistance, had considerably increased risk of CHD and CVD.
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