High Mortality Risk in Normal Weight Adults at Diabetes Diagnosis

Normal weight adults had higher mortality rates at diabetes diagnosis compared to overweight or obese adults, according to a study published on Aug. 7 in The Journal of the American Medical Association


The study found rates of total, cardiovascular and noncardiovascular mortality to be higher in normal-weight participants (284.8, 99.8, and 198.1 per 10,000 person-years, respectively) than in overweight/obese participants (152.1, 67.8, and 87.9 per 10,000 person-years, respectively). Further, after adjustment for "demographic characteristics and blood pressure, lipid levels, waist circumference, and smoking status, hazard ratios comparing normal-weight participants with overweight/obese participants for total, cardiovascular and noncardiovascular mortality were 2.08 (95 percent CI, 1.52-2.85), 1.52 (95 percent CI, 0.89-2.58), and 2.32 (95 percent CI, 1.55-3.48), respectively."


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The study looked at 2,625 patients within five longitudinal cohort studies and included men and women older than 40 years old "who developed incident diabetes based on fasting glucose 12 mg/dL or greater or newly initiated diabetes medication and who had concurrent measurements of body mass index (BMI)."


"This study adds an important dimension to the evidence supporting the obesity paradox in diabetes, as it is the first to measure BMI at the time of onset diabetes, eliminating the potential confounding effects of diabetes duration," note Hermes Florez, MD, MPH, PhD, and Sumaya Castillo-Florez, MD, MPH, from the Department of Medicine and Epidemiology and Public Health, University of Miami Miller School of Medicine, Geriatrics Research, Education, and Clinical Center, Miami, FL, in an editorial comment.

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