Body Weight Variability and the Risk of Cardiovascular Outcomes and Mortality in Patients With Type 2 Diabetes: A Nationwide Cohort Study

被引:56
作者
Nam, Ga Eun [1 ]
Kim, Wonsock [1 ]
Han, Kyungdo [2 ,3 ]
Lee, Chung-woo [1 ]
Kwon, Yeongkeun [1 ]
Han, Byoungduck [1 ]
Park, Seokwon [1 ]
Park, Joo-Hyun [1 ]
Kim, Yang-Hyun [1 ]
Kim, Do-Hoon [1 ]
Kim, Seon Mee [1 ]
Choi, Youn Seon [1 ]
Cho, Kyung Hwan [1 ]
Park, Yong Gyu [2 ]
机构
[1] Korea Univ, Coll Med, Dept Family Med, Seoul, South Korea
[2] Catholic Univ, Dept Biostat, Seoul, South Korea
[3] Soongsil Univ, Dept Stat & Actuarial Sci, Seoul, South Korea
关键词
LOSS MAINTENANCE; ADIPOSE-TISSUE; ABDOMINAL FAT; MASS INDEX; DISEASE; OBESITY; INTERVENTION; ACCUMULATION; ASSOCIATION; FLUCTUATION;
D O I
10.2337/dc19-2552
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVE Obesity and type 2 diabetes are risk factors for cardiovascular diseases and mortality, and they commonly result in weight variabilities. We aimed to investigate the association between body weight variability and risk of major cardiovascular outcomes and mortality in individuals with type 2 diabetes using large-scale, nationwide cohort data on the Korean population. RESEARCH DESIGN AND METHODS We enrolled 624,237 individuals with type 2 diabetes who underwent health examinations provided by the Korean National Health Insurance System between 2009 and 2010, with three or more body weight measurements within 5 years since enrollment and followed up until the end of 2017. We assessed body weight variability using four indices, including variability independent of the mean (VIM). A multivariate-adjusted Cox proportional hazards regression analysis was performed. RESULTS During the follow-up, 15,832, 25,038, and 44,716 cases of myocardial infarction (MI), stroke, and all-cause mortality, respectively, were recorded. Body weight variability was associated with increased risks of major cardiovascular outcomes after adjusting for confounding variables. Compared with the hazard ratios (HRs) of the lowest quartile group, the HRs (95% CIs) of the highest quartile group of VIM for body weight were 1.15 (1.10-1.20), 1.22 (1.18-1.26), and 1.58 (1.53-1.62) for MI, stroke, and all-cause mortality, respectively. CONCLUSIONS Body weight variability was associated with increased risks of MI, stroke, and all-cause mortality in patients with type 2 diabetes and may be a predictor of cardiovascular outcomes in such patients. Appropriate interventions to maintain stable weight could positively influence health outcomes in patients with type 2 diabetes.
引用
收藏
页码:2234 / 2241
页数:8
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