Available online 17 January 2023, 101426
Author links open overlay panelAbstractAimTo investigate the associations of baseline body mass index (BMI) and longitudinal BMI trajectories with all-cause mortality among patients with type 2 diabetes mellitus (T2DM).
Methods,We used data from the diabetes surveillance system of Yinzhou Health Information System with T2DM patients registered from 2010 to 2015. Participants aged ≥ 40 years were included and were followed up until September 30, 2021. The latent class growth mixture model was used to identify different changing patterns in BMI for 5 years from registration. Cox proportional hazards models were used to examine the associations of baseline BMI and 5-year BMI trajectories with all-cause mortality.
ResultsWe observed a nonlinear association between baseline BMI and all-cause mortality (P for nonlinearity < 0.001), with an increased risk of death for low but not high BMI. However, compared with participants with medium-stable BMI for 5 years from baseline, individuals with increasing BMI had higher mortality, with adjusted hazard ratios (95% confidence intervals) 1.21 (1.02;1.43) for early-increasing and 1.47 (1.19;1.80) for late-sharp increasing groups.
ConclusionThese findings suggest that while obesity itself may not be associated with an increased risk for mortality, weight gain, and in particular rapid weight gain, is a risk factor for mortality among patients with T2DM.
KeywordsBMI
Mortality
Trajectory analysis
Type 2 diabetes
AbbreviationsYHISYinzhou Health Information System
SBPsystolic blood pressure
ICD-10International Classification of Diseases, Tenth Revision
RCSrestricted cubic splines
T2DMtype 2 diabetes mellitus
LCGMMlatent class growth mixed model
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