Oliver Brown1, Pierluigi Costanzo1, Andrew L Clark1, Gianluigi Condorelli2, John G F Cleland3, Thozhukat Sathyapalan4, David Hepburn4, Eric S Kilpatrick5, Stephen L Atkin6. 1. Academic Cardiology Unit, Hull York Medical School, University of Hull, Castle Hill Hospital, Cottingham, UK. 2. Department of Cardiovascular Medicine, Humanitas, Milan, Italy. 3. Robertson Centre for Biostatistics, University of Glasgow, Glasgow. 4. Unit of Endocrinology and Metabolism, Hull York Medical School, Hull, UK. 5. Sidra Medicine, Sidra Medical and Research Center, Doha, Qatar. 6. Department of Research, Royal College of Surgeons in Ireland and Medical University of Bahrain, Busaiteen, Bahrain.
Abstract
OBJECTIVE: This study aims to evaluate the relationship between a single measurement at baseline of body mass index (BMI), glycated hemoglobin (HbA1c) and subsequent clinical outcomes in patients with type 2 diabetes mellitus (T2DM). METHOD: Patients with T2DM were recruited from an outpatient diabetes clinic in a single large teaching hospital in Kingston upon Hull, UK. At baseline, demographics and HbA1c were recorded. Patients were categorized by BMI: normal weight (18.5-24.9 kg/m2), overweight (25-29.9 kg/m2), and obese (>30 kg/m2). Multivariable Cox regression models that included demographic, risk factors, and comorbidities were separately constructed for all-cause, cardiovascular, cancer and sepsis-related mortality, using four groups of HbA1c (<6%, 6.0-6.9%, 7.0-7.9%, and >8%). RESULTS: In total, 6220 patients with T2DM (median age 62 years, 54% male) were followed for a median of 10.6 years. HbA1c levels >8.0% were associated with increased risk of all-cause mortality and cardiovascular death. However, this increased risk was not consistent across the weight categories and reached statistical significance only in overweight patients (BMI 25-29.9 kg/m2). CONCLUSIONS: In a large cohort of patients with T2DM elevated HbA1c levels at baseline did not consistently predict increased risk of all-cause and cardiovascular mortality across the different BMI categories.
OBJECTIVE: This study aims to evaluate the relationship between a single measurement at baseline of body mass index (BMI), glycated hemoglobin (HbA1c) and subsequent clinical outcomes in patients with type 2 diabetes mellitus (T2DM). METHOD: Patients with T2DM were recruited from an outpatient diabetes clinic in a single large teaching hospital in Kingston upon Hull, UK. At baseline, demographics and HbA1c were recorded. Patients were categorized by BMI: normal weight (18.5-24.9 kg/m2), overweight (25-29.9 kg/m2), and obese (>30 kg/m2). Multivariable Cox regression models that included demographic, risk factors, and comorbidities were separately constructed for all-cause, cardiovascular, cancer and sepsis-related mortality, using four groups of HbA1c (<6%, 6.0-6.9%, 7.0-7.9%, and >8%). RESULTS: In total, 6220 patients with T2DM (median age 62 years, 54% male) were followed for a median of 10.6 years. HbA1c levels >8.0% were associated with increased risk of all-cause mortality and cardiovascular death. However, this increased risk was not consistent across the weight categories and reached statistical significance only in overweight patients (BMI 25-29.9 kg/m2). CONCLUSIONS: In a large cohort of patients with T2DM elevated HbA1c levels at baseline did not consistently predict increased risk of all-cause and cardiovascular mortality across the different BMI categories.
Authors: Rik P Bogers; Wanda J E Bemelmans; Rudolf T Hoogenveen; Hendriek C Boshuizen; Mark Woodward; Paul Knekt; Rob M van Dam; Frank B Hu; Tommy L S Visscher; Alessandro Menotti; Roland J Thorpe; Konrad Jamrozik; Susanna Calling; Bjørn Heine Strand; Martin J Shipley Journal: Arch Intern Med Date: 2007-09-10
Authors: Beverley Balkau; Françoise Calvi-Gries; Nick Freemantle; Maya Vincent; Valerie Pilorget; Philip D Home Journal: Diabetes Res Clin Pract Date: 2015-03-12 Impact factor: 5.602
Authors: Doti P Martono; Eelko Hak; Hiddo Lambers Heerspink; Bob Wilffert; Petra Denig Journal: Curr Med Res Opin Date: 2016-09-20 Impact factor: 2.580
Authors: Kenneth F Adams; Arthur Schatzkin; Tamara B Harris; Victor Kipnis; Traci Mouw; Rachel Ballard-Barbash; Albert Hollenbeck; Michael F Leitzmann Journal: N Engl J Med Date: 2006-08-22 Impact factor: 91.245
Authors: Sanne N van Munster; Yolanda van der Graaf; Harold W de Valk; Frank L J Visseren; Jan Westerink Journal: Diabetes Obes Metab Date: 2016-12-28 Impact factor: 6.577
Authors: Elizabeth Selvin; Spyridon Marinopoulos; Gail Berkenblit; Tejal Rami; Frederick L Brancati; Neil R Powe; Sherita Hill Golden Journal: Ann Intern Med Date: 2004-09-21 Impact factor: 25.391
Authors: Weiqin Li; Peter T Katzmarzyk; Ronald Horswell; Yujie Wang; Jolene Johnson; Gang Hu Journal: Int J Cardiol Date: 2015-09-26 Impact factor: 4.164
Authors: E L Massó González; S Johansson; M-A Wallander; L A García Rodríguez Journal: J Epidemiol Community Health Date: 2009-02-24 Impact factor: 3.710