Type 2 Diabetes: U-shaped Association of BMI With All-Cause Mortality

Gang Hu, MD, MPH, PhD, FAHA Assistant professor & Director, Chronic Disease Epidemiology Lab Adjunct assistant professor, School of Public Health, LSU Health Sciences Center Pennington Biomedical Research Center, Baton Rouge, LouisianaMedicalResearch.com Interview with:
Gang Hu, MD, MPH, PhD, FAHA
Assistant professor & Director
Chronic Disease Epidemiology Lab
Adjunct assistant professor, School of Public Health
LSU Health Sciences Center
Pennington Biomedical Research Center,
Baton Rouge, Louisiana
Medical Research: What is the background for this study? What are the main findings?

Dr. Hu: Many previous studies had small samples, and thus lacked adequate statistical power when the analysis was focused on those who are extremely obese (BMI ≥40 kg/m2). In addition, most epidemiological studies only use a single measurement of BMI at baseline to predict risk of all-cause mortality, which may produce potential bias. The current study indicated a U-shaped association of BMI with all-cause mortality risk among African American and white patients with type 2 diabetes. A significantly increased risk of all-cause mortality was observed among African Americans with BMI<30 kg/m2 and BMI ≥35 kg/m2, and among whites with BMI<25 kg/m2 and BMI ≥40 kg/m2 compared with patients with BMI 30-34.9 kg/m2.

Medical Research: What should clinicians and patients take away from your report?

Dr. Hu: A significantly increased risk of all-cause mortality was observed among African Americans with BMI<30 kg/m2 and BMI ≥35 kg/m2, and among whites with BMI<25 kg/m2 and BMI ≥40 kg/m2 compared with patients with BMI 30-34.9 kg/m2. Since our study samples are diabetic, patients need to use drug treatment to control glucose, blood pressure, lipids and kidney disease and also need to do lifestyle intervention to increase exercise and modify diet to control diabetic complication.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Hu: The future studies are needed to study the potential explanations and mechanism of this U-shaped association between BMI and all-cause mortality risk among patients with type 2 diabetes.

Citation:

Body Mass Index and the Risk of All-Cause Mortality Among Patients with Type 2 Diabetes

Wenhui Zhao, Peter T. Katzmarzyk, Ronald Horswell, Yujie Wang, Weiqin Li, Jolene Johnson, Steven B. Heymsfield, William T. Cefalu, Donna H. Ryan, and Gang Hu

Circulation. 2014;CIRCULATIONAHA.114.009098published online before print November 5 2014, doi:10.1161/CIRCULATIONAHA.114.009098

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