Abstract
Objective We conducted a systematic review and meta-analysis of studies to quantify the association between body mass index (BMI) and the risks of all-cause and cardiovascular mortality in patients with type 2 diabetes. Methods We included studies assessing the impact of BMI on all-cause and cardiovascular mortality in patients with type 2 diabetes. Data were combined using a random-effects dose-response model. Results Sixteen cohort studies on all-cause mortality (n = 445,125) and two studies on cardiovascular mortality (n = 92,841) were evaluated in the meta-analysis. A non-linear association was observed between BMI and all-cause mortality among patients with type 2 diabetes. With a BMI nadir of 28-30 kg/m2, the risk of all-cause mortality displayed a U-shaped increase. With a BMI nadir of 29-31 kg/m2, the risk of cardiovascular mortality exhibited a gradual non-linear increase for BMI>31 kg/m2. Subgroup analyses suggested that study location, diabetes duration, and smoking history may have contributed to heterogeneity among the studies. Conclusions An obesity paradox exists for patients with type 2 diabetes with respect to all-cause and cardiovascular mortality. Study location, diabetes duration, and smoking history might contribute to heterogeneity among obesity paradox studies of patients with type 2 diabetes.
| Original language | English |
|---|---|
| Article number | 0168247 |
| Journal | PLoS One |
| Volume | 12 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 2017 Jan 1 |
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ASJC Scopus subject areas
- Biochemistry, Genetics and Molecular Biology(all)
- Agricultural and Biological Sciences(all)
Cite this
Body mass index-related mortality in patients with type 2 diabetes and heterogeneity in obesity paradox studies : A dose-response meta-analysis. / Kwon, Yeongkeun; Kim, Hyun Jung; Park, Sungsoo; Park, Yong Gyu; Cho, Kyung-Hwan.
In: PLoS One, Vol. 12, No. 1, 0168247, 01.01.2017.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Body mass index-related mortality in patients with type 2 diabetes and heterogeneity in obesity paradox studies
T2 - A dose-response meta-analysis
AU - Kwon, Yeongkeun
AU - Kim, Hyun Jung
AU - Park, Sungsoo
AU - Park, Yong Gyu
AU - Cho, Kyung-Hwan
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Objective We conducted a systematic review and meta-analysis of studies to quantify the association between body mass index (BMI) and the risks of all-cause and cardiovascular mortality in patients with type 2 diabetes. Methods We included studies assessing the impact of BMI on all-cause and cardiovascular mortality in patients with type 2 diabetes. Data were combined using a random-effects dose-response model. Results Sixteen cohort studies on all-cause mortality (n = 445,125) and two studies on cardiovascular mortality (n = 92,841) were evaluated in the meta-analysis. A non-linear association was observed between BMI and all-cause mortality among patients with type 2 diabetes. With a BMI nadir of 28-30 kg/m2, the risk of all-cause mortality displayed a U-shaped increase. With a BMI nadir of 29-31 kg/m2, the risk of cardiovascular mortality exhibited a gradual non-linear increase for BMI>31 kg/m2. Subgroup analyses suggested that study location, diabetes duration, and smoking history may have contributed to heterogeneity among the studies. Conclusions An obesity paradox exists for patients with type 2 diabetes with respect to all-cause and cardiovascular mortality. Study location, diabetes duration, and smoking history might contribute to heterogeneity among obesity paradox studies of patients with type 2 diabetes.
AB - Objective We conducted a systematic review and meta-analysis of studies to quantify the association between body mass index (BMI) and the risks of all-cause and cardiovascular mortality in patients with type 2 diabetes. Methods We included studies assessing the impact of BMI on all-cause and cardiovascular mortality in patients with type 2 diabetes. Data were combined using a random-effects dose-response model. Results Sixteen cohort studies on all-cause mortality (n = 445,125) and two studies on cardiovascular mortality (n = 92,841) were evaluated in the meta-analysis. A non-linear association was observed between BMI and all-cause mortality among patients with type 2 diabetes. With a BMI nadir of 28-30 kg/m2, the risk of all-cause mortality displayed a U-shaped increase. With a BMI nadir of 29-31 kg/m2, the risk of cardiovascular mortality exhibited a gradual non-linear increase for BMI>31 kg/m2. Subgroup analyses suggested that study location, diabetes duration, and smoking history may have contributed to heterogeneity among the studies. Conclusions An obesity paradox exists for patients with type 2 diabetes with respect to all-cause and cardiovascular mortality. Study location, diabetes duration, and smoking history might contribute to heterogeneity among obesity paradox studies of patients with type 2 diabetes.
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U2 - 10.1371/journal.pone.0168247
DO - 10.1371/journal.pone.0168247
M3 - Article
C2 - 28046128
AN - SCOPUS:85008489998
VL - 12
JO - PLoS One
JF - PLoS One
SN - 1932-6203
IS - 1
M1 - 0168247
ER -