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Changes in body mass index following newly diagnosed type 2 diabetes and risk of cardiovascular mortality: A cohort study of 8486 primary-care patients

Bodegard, J.; Sundstrom, J.; Svennblad, B.; Ostgren, C. J.; Nilsson, Peter LU and Johansson, G. (2013) In Diabetes & Metabolism 39(4). p.306-313
Abstract
Aims. - Elevated body mass index (BMI) is associated with an increased risk of type 2 diabetes and cardiovascular disease (CVD). This study explored the association between BMI changes in the first 18 months of newly diagnosed type 2 diabetes and the risk of long-term CVD mortality. Methods. - A total of 8486 patients with newly diagnosed type 2 diabetes and no previous history of CVD or cancer were identified from 84 primary-care centres in Sweden. During the first year after diagnosis, patients were grouped according to BMI change: 'Increase', or >= +1 BMI unit; 'unchanged', or between +1 and-1 BMI unit; and 'decrease', or <=-1 BMI unit. Associations between BMI change and CVD mortality, defined as death from stroke, myocardial... (More)
Aims. - Elevated body mass index (BMI) is associated with an increased risk of type 2 diabetes and cardiovascular disease (CVD). This study explored the association between BMI changes in the first 18 months of newly diagnosed type 2 diabetes and the risk of long-term CVD mortality. Methods. - A total of 8486 patients with newly diagnosed type 2 diabetes and no previous history of CVD or cancer were identified from 84 primary-care centres in Sweden. During the first year after diagnosis, patients were grouped according to BMI change: 'Increase', or >= +1 BMI unit; 'unchanged', or between +1 and-1 BMI unit; and 'decrease', or <=-1 BMI unit. Associations between BMI change and CVD mortality, defined as death from stroke, myocardial infarction or sudden death, were estimated using adjusted Cox proportional hazards models (NCT 01121315). Results. - Baseline mean age was 60.0 years and mean BMI was 30.2 kg/m(2). Patients were followed for up to 9 years (median: 4.6 years). During the first 18 months, 53.4% had no change in their BMI, while 32.2% decreased and 14.4% increased. Compared with patients with unchanged BMI, those with an increased BMI had higher risks of CVD mortality (hazard ratio: 1.63, 95% CI: 1.11-2.39) and all-cause mortality (1.33, 1.01-1.76). BMI decreases had no association with these risks compared with unchanged BMI: 1.06 (0.76-1.48) and 1.06 (0.85-1.33), respectively. Conclusion. - Increased BMI within the first 18 months of type 2 diabetes diagnosis was associated with an increased long-term risk of CVD mortality. However, BMI decrease did not lower the long-term risk of mortality. (C) 2013 Elsevier Masson SAS. All rights reserved. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Epidemiology, Type 2 diabetes, Weight control, Cardiovascular disease, mortality
in
Diabetes & Metabolism
volume
39
issue
4
pages
306 - 313
publisher
Masson Editeur
external identifiers
  • wos:000326356900004
  • scopus:84883782869
ISSN
1878-1780
DOI
10.1016/j.diabet.2013.05.004
language
English
LU publication?
yes
id
1fc0252c-63eb-448a-8d2d-829e69c62428 (old id 4212370)
date added to LUP
2014-01-03 10:47:59
date last changed
2019-08-14 02:31:03
@article{1fc0252c-63eb-448a-8d2d-829e69c62428,
  abstract     = {Aims. - Elevated body mass index (BMI) is associated with an increased risk of type 2 diabetes and cardiovascular disease (CVD). This study explored the association between BMI changes in the first 18 months of newly diagnosed type 2 diabetes and the risk of long-term CVD mortality. Methods. - A total of 8486 patients with newly diagnosed type 2 diabetes and no previous history of CVD or cancer were identified from 84 primary-care centres in Sweden. During the first year after diagnosis, patients were grouped according to BMI change: 'Increase', or &gt;= +1 BMI unit; 'unchanged', or between +1 and-1 BMI unit; and 'decrease', or &lt;=-1 BMI unit. Associations between BMI change and CVD mortality, defined as death from stroke, myocardial infarction or sudden death, were estimated using adjusted Cox proportional hazards models (NCT 01121315). Results. - Baseline mean age was 60.0 years and mean BMI was 30.2 kg/m(2). Patients were followed for up to 9 years (median: 4.6 years). During the first 18 months, 53.4% had no change in their BMI, while 32.2% decreased and 14.4% increased. Compared with patients with unchanged BMI, those with an increased BMI had higher risks of CVD mortality (hazard ratio: 1.63, 95% CI: 1.11-2.39) and all-cause mortality (1.33, 1.01-1.76). BMI decreases had no association with these risks compared with unchanged BMI: 1.06 (0.76-1.48) and 1.06 (0.85-1.33), respectively. Conclusion. - Increased BMI within the first 18 months of type 2 diabetes diagnosis was associated with an increased long-term risk of CVD mortality. However, BMI decrease did not lower the long-term risk of mortality. (C) 2013 Elsevier Masson SAS. All rights reserved.},
  author       = {Bodegard, J. and Sundstrom, J. and Svennblad, B. and Ostgren, C. J. and Nilsson, Peter and Johansson, G.},
  issn         = {1878-1780},
  keyword      = {Epidemiology,Type 2 diabetes,Weight control,Cardiovascular disease,mortality},
  language     = {eng},
  number       = {4},
  pages        = {306--313},
  publisher    = {Masson Editeur},
  series       = {Diabetes & Metabolism},
  title        = {Changes in body mass index following newly diagnosed type 2 diabetes and risk of cardiovascular mortality: A cohort study of 8486 primary-care patients},
  url          = {http://dx.doi.org/10.1016/j.diabet.2013.05.004},
  volume       = {39},
  year         = {2013},
}