Weight change and mortality and cardiovascular outcomes in patients with new-onset diabetes mellitus: a nationwide cohort studyopen access
- Authors
- Kim, Mee Kyoung; Han, Kyungdo; Koh, Eun Sil; Kim, Eun Sook; Lee, Min-Kyung; Nam, Ga Eun; Kwon, Hyuk-Sang
- Issue Date
- Mar-2019
- Publisher
- BioMed Central
- Keywords
- Weight changes; Type 2 diabetes mellitus; Cardiovascular disease
- Citation
- Cardiovascular Diabetology, v.18
- Indexed
- SCIE
SCOPUS
- Journal Title
- Cardiovascular Diabetology
- Volume
- 18
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/65473
- DOI
- 10.1186/s12933-019-0838-9
- ISSN
- 1475-2840
- Abstract
- BackgroundBecause weight control is a cornerstone of diabetes management, it is important to understand the relationship of weight change to risk of cardiovascular disease (CVD) among patients with type 2 diabetes mellitus (DM). We aimed to investigate whether changes in weight early after diagnosis influence the incidence of CVD and all-cause mortality in patients with type 2 DM.MethodsUsing nationally representative data from the Korean National Health Insurance System, 173,246 subjects with new-onset DM who underwent health examinations during 2007-2012 were included. Weight was measured at the time of diabetes diagnosis and 2years later. Weight change over 2years was divided into five categories of 5% weight change, from weight loss -10% to weight gain 10%.ResultsThere were 3113 deaths (1.8%), 2060 cases of stroke (1.2%), and 1767 myocardial infarctions (MIs) (1.0%) during a median follow-up of 5.5years. Subjects with weight gain 10% had a significantly higher risk of stroke (hazard ratio [HR] 1.51, 95% confidence interval [CI] 1.23-1.84), compared with the group with stable weight. There was no significant association between weight change after diagnosis of DM and incident MI. All-cause mortality showed a U-shaped curve according to weight change. The group with weight loss -10% had the highest HR for all-cause mortality (HR 1.86; 95% CI 1.61-2.14) and the HR for weight gain 10% was 1.61 (95% CI 1.37-1.89).ConclusionsWeight changes of more than 10% after diabetes diagnosis were associated with higher mortality and over 10% weight gain was associated with increased risk of stroke.
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