Jinbo Hu1,2, Yang Hu1, Ellen Hertzmark3, Chen Yuan4, Gang Liu1,5, Meir J Stampfer1,6,7, Eric B Rimm1,6,7, Frank B Hu1,6,7, Molin Wang7,8, Qi Sun1,6,7,9. 1. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA. 2. Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China. 3. Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA. 4. Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA. 5. Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. 6. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA. 7. Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. 8. Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA. 9. Joslin Diabetes Center, One Joslin Place, Boston, MA, USA.
Abstract
CONTEXT: The association between weight change and mortality among participants with incident type 2 diabetes (T2D) was unclear. OBJECTIVE: To examine above association and evaluate the impact of lifestyle on it. METHODS: This prospective analysis included 11 262 incident T2D patients from Nurses' Health Study and Health Professionals Follow-up Study. We assessed weight change bracketing T2D diagnosis in relation to mortality. We also examined potential effect modification by a healthy lifestyle consisting of high-quality diet, regular physical activity, nonsmoking status, and moderate alcohol consumption. RESULTS: On average, T2D patients lost 2.3 kg during a 2-year time window spanning the T2D diagnosis, and body weight increased afterwards following a trajectory similar to that of nondiabetics. Compared with patients with a stable weight, T2D patients who lost ≥10% body weight had a 21% (95% CI, 9%-35%) increased all-cause mortality. Lifestyle significantly modified these associations: the hazard ratios (95% CIs) of all-cause mortality comparing ≥10% weight loss with stable weight were 1.63 (1.26-2.09) among participants with a deteriorated lifestyle, 1.27 (1.11-1.46) for a stable lifestyle, and 1.02 (0.81-1.27) for an improved lifestyle (Pinteraction < 0.001). Major weight loss was associated with increased cause-specific mortality and similar effect modifications by lifestyle were also observed. CONCLUSION: Significant weight loss upon T2D incidence was associated with increased mortality, although improved lifestyle quality abolished these associations. These results highlight the role of adopting a healthy lifestyle for newly diagnosed T2D patients, especially among those who might lose weight unintentionally, and improving long-term survival.
CONTEXT: The association between weight change and mortality among participants with incident type 2 diabetes (T2D) was unclear. OBJECTIVE: To examine above association and evaluate the impact of lifestyle on it. METHODS: This prospective analysis included 11 262 incident T2D patients from Nurses' Health Study and Health Professionals Follow-up Study. We assessed weight change bracketing T2D diagnosis in relation to mortality. We also examined potential effect modification by a healthy lifestyle consisting of high-quality diet, regular physical activity, nonsmoking status, and moderate alcohol consumption. RESULTS: On average, T2D patients lost 2.3 kg during a 2-year time window spanning the T2D diagnosis, and body weight increased afterwards following a trajectory similar to that of nondiabetics. Compared with patients with a stable weight, T2D patients who lost ≥10% body weight had a 21% (95% CI, 9%-35%) increased all-cause mortality. Lifestyle significantly modified these associations: the hazard ratios (95% CIs) of all-cause mortality comparing ≥10% weight loss with stable weight were 1.63 (1.26-2.09) among participants with a deteriorated lifestyle, 1.27 (1.11-1.46) for a stable lifestyle, and 1.02 (0.81-1.27) for an improved lifestyle (Pinteraction < 0.001). Major weight loss was associated with increased cause-specific mortality and similar effect modifications by lifestyle were also observed. CONCLUSION: Significant weight loss upon T2D incidence was associated with increased mortality, although improved lifestyle quality abolished these associations. These results highlight the role of adopting a healthy lifestyle for newly diagnosed T2D patients, especially among those who might lose weight unintentionally, and improving long-term survival.
Authors: Gang Liu; Yanping Li; Yang Hu; Geng Zong; Shanshan Li; Eric B Rimm; Frank B Hu; JoAnn E Manson; Kathryn M Rexrode; Hyun Joon Shin; Qi Sun Journal: J Am Coll Cardiol Date: 2018-06-26 Impact factor: 24.094
Authors: Ebenezer S Adjah Owusu; Mayukh Samanta; Jonathan E Shaw; Azeem Majeed; Kamlesh Khunti; Sanjoy K Paul Journal: Nutr Diabetes Date: 2018-06-01 Impact factor: 5.097
Authors: Jingjing Jiao; Gang Liu; Hyun Joon Shin; Frank B Hu; Eric B Rimm; Kathryn M Rexrode; JoAnn E Manson; Geng Zong; Qi Sun Journal: BMJ Date: 2019-07-02