Body mass index-related mortality in patients with type 2 diabetes and heterogeneity in obesity paradox studies: A dose-response meta-analysis

Yeongkeun Kwon, Hyun Jung Kim, Sungsoo Park, Yong Gyu Park, Kyung Hwan Cho

Research output: Contribution to journalArticlepeer-review

66 Citations (Scopus)

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 languageEnglish
Article number0168247
JournalPloS one
Volume12
Issue number1
DOIs
Publication statusPublished - 2017 Jan
Externally publishedYes

Bibliographical note

Publisher Copyright:
© Copyright: 2017 Kwon et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

ASJC Scopus subject areas

  • General

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