Affiliation:
1. Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan 430030 , P. R. China
2. Department of Community Health Management, Baoan District Central Hospital , S henzhen 518102 , P. R. China
Abstract
Abstract
Context
Weight management is recognized as critical in reducing cardiometabolic risk factors for adults with diabetes, but the effects of weight change on cardiovascular disease in patients with diabetes are unknown.
Objective
To evaluate 18-month weight change and subsequent risk of macrovascular and microvascular complications in established individuals with type 2 diabetes.
Design and Setting
This study consisted of a cohort study and a meta-analysis. In the cohort study, weight change over 18 months was divided into gain ≥ 5%, gain 1% to 5%, stable -1% to 1%, loss 1% to 5%, and loss ≥ 5%. Cox regression analyses were used to estimate hazard ratios (HRs) and 95% CIs. We then used random-effect models to pool the results combing our study with other relevant studies.
Results
In the cohort study, 8920 participants with valid weight measurements were included. Compared with patients with stable weight, higher risks were seen in those with weight change for total vascular complications (gain ≥ 5%: HR = 1.43, 95% CI, 1.10-1.85; gain 1%-5%: HR = 1.44, 95% CI, 1.02-2.03; loss ≥ 5%: HR = 1.58, 95% CI, 1.20-2.08), macrovascular complications (gain ≥ 5%: HR = 1.84, 95% CI, 1.16-2.91; loss 1%-5%: HR = 1.91, 95% CI, 1.06-3.43; loss ≥ 5%: HR = 2.18, 95% CI, 1.36-3.49) and microvascular complications (loss ≥ 5%: HR = 1.48, 95% CI: 1.06–2.06). Meta-analysis also showed similar results.
Conclusions
Weight gain and loss over 18 months among patients with type 2 diabetes, especially weight change ≥ 5%, may be a warning sign of adverse cardiovascular outcomes.
Subject
Biochemistry (medical),Clinical Biochemistry,Endocrinology,Biochemistry,Endocrinology, Diabetes and Metabolism
Cited by
2 articles.
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