Body weight time in target range and cardiovascular outcomes in adults with overweight/obesity and type 2 diabetes

Author:

Liu Menghui12ORCID,Xu Xingfeng12,Chen Xiaohong3,Guo Yue12,Zhang Shaozhao12,Lin Yifen12,Zhou Huimin12,Li Miaohong12ORCID,Xie Peihan12,Xia Wenhao4,Wang Lichun12,Zhuang Xiaodong12ORCID,Liao Xinxue12ORCID

Affiliation:

1. Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University , 58 Zhongshan 2nd Rd, Guangzhou 510080 , China

2. NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University) , 74 Zhongshan 2nd Rd, Guangzhou 510080 , China

3. Department of Otorhinolaryngology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China

4. Department of Hypertension and Vascular Disease, The First Affiliated Hospital, Sun Yat-sen University , Guangzhou , China

Abstract

Abstract Aims Prescription of weight loss to individuals is often characterized by weight fluctuations. However, current body weight management metrics may have difficulty characterizing the changes in body weight over time. We aim to characterize the long-term changes using body weight time in target range (TTR) and test its independent association with cardiovascular outcomes. Methods and results We included 4468 adults from the Look AHEAD (Action for Health in Diabetes) trial. Body weight TTR was defined as the percentage of time during which body weight was within the Look AHEAD weight loss goal range. The associations of body weight TTR with cardiovascular outcomes were analysed using multivariable Cox modelling and restricted cubic spline function. Among the participants (mean age 58.9 years, 58.5% women, 66.5% White), there were 721 incident primary outcomes [cumulative incidence: 17.5%, 95% confidence interval (CI): 16.3–18.8%] during a median of 9.5 years of follow-up. Each 1 SD increase in body weight TTR was significantly associated with a decreased risk of the primary outcome (hazard ratio: 0.84, 95% CI: 0.75–0.94) after adjusting for mean and variability of body weight and traditional cardiovascular risk factors. Further analyses using restricted cubic spline indicated the inverse association between body weight TTR and the primary outcome in a dose-dependent manner. Similar associations remained significant among the participants with lower baseline or mean body weight. Conclusion In adults with overweight/obesity and type 2 diabetes, higher body weight TTR was independently associated with lower risks of cardiovascular adverse events in a dose–response manner.

Funder

National Natural Science Foundation of China

Guangdong Basic and Applied Basic Research Foundation

China Postdoctoral Science Foundation

NIDDK

National Institute of Nursing Research

National Heart, Lung, and Blood Institute

Office of Research on Women’s Health

National Institute of Minority Health and Health Disparities

Centers for Disease Control and Prevention

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine,Epidemiology

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