Body Mass Index-Related Mortality in Patients with Type 2 Diabetes and Heterogeneity in Obesity Paradox Studies: A Dose-Response Meta-Analysis
- Authors
- Kwon, Yeongkeun; Kim, Hyun Jung; Park, Sungsoo; Park, Yong-Gyu; Cho, Kyung-Hwan
- Issue Date
- 3-1월-2017
- Publisher
- PUBLIC LIBRARY SCIENCE
- Citation
- PLOS ONE, v.12, no.1
- Indexed
- SCIE
SCOPUS
- Journal Title
- PLOS ONE
- Volume
- 12
- Number
- 1
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/84950
- DOI
- 10.1371/journal.pone.0168247
- ISSN
- 1932-6203
- 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/m(2), the risk of all-cause mortality displayed a U-shaped increase. With a BMI nadir of 29 - 31 kg/m(2), the risk of cardiovascular mortality exhibited a gradual non-linear increase for BMI > 31 kg/m(2). 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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