The association of body mass index with the risk of type 2 diabetes: a case–control study nested in an electronic health records system in the United States

Abstract

ObjectivesObesity is a known risk factor for type 2 diabetes (T2D). We conducted a case–control study to assess the association between body mass index (BMI) and the risk of being diagnosed with T2D in the United States.MethodsWe selected adults (≥ 18 years old) who were diagnosed with T2D (defined by ICD-9-CM diagnosis codes or use of anti-diabetic medications) between January 2004 and October 2011 (“cases”) from an electronic health records database provided by an integrated health system in the Middle Atlantic region. Twice as many individuals enrolled in the health system without a T2D diagnosis during the study period (“controls”) were selected based on age, sex, history of cardiac comorbidities or hyperinflammatory state (defined by C-reactive protein and erythrocyte sedimentation rate), and use of psychiatric or beta blocker medications. BMI was measured during one year prior to the first observed T2D diagnosis (for cases) or a randomly assigned date (for controls); individuals with no BMI measure or BMI < 18.5 kg/m2 were excluded. We assessed the impact of increased BMI (overweight: 25–29.9 kg/m2; Obesity Class I: 30–34.9 kg/m2; Obesity Class II: 35–39.9 kg/m2; Obesity Class III: ≥40 kg/m2), relative to normal BMI (18.5–24.9 kg/m2), on a T2D diagnosis using odds ratios (OR) and relative risks (RR) estimated from multiple logistic regression results.ResultsWe included 12,179 cases (mean age: 55, 43% male) and 25,177 controls (mean age: 56, 45% male). We found a positive association between BMI and the risk of a T2D diagnosis. The strength of this association increased with BMI category (RR [95% confidence interval]: overweight, 1.5 [1.4–1.6]; Obesity Class I, 2.5 [2.3–2.6]; Obesity Class II, 3.6 [3.4–3.8]; Obesity Class III, 5.1 [4.7–5.5]).ConclusionsBMI is strongly and independently associated with the risk of being diagnosed with T2D. The incremental association of BMI category on the risk of T2D is stronger for people with a higher BMI relative to people with a lower BMI.

Characteristics of Hospitalised Patients at the Lowest and Highest Ends of the Body Mass Index Spectrum

“…For example, obesity has been closely linked to type II diabetes [17], and the notion that depression may have a u-curved association with BMI has been asserted previously [18] and is supported in the current study. Similarly, gastrointestinal disorders have been linked to both the obese [19] and underweight groups [20].…”

Categorization of relative risk of diseases with relation to stress, body mass index and anthropometric markers: A cross-sectional study in general population of Karachi, Pakistan

“…Term 'overweight' in categorization of BMI was classified as the increased risk status that substantially increases lifetime risk of diagnosed diabetes (Meigs et al, 2006). Moreover, Ganz et al (2014), strongly correlated the levels of BMI with risk of being diagnosed with T2DM, as individual with higher BMI has higher risk of T2DM as compared with a lower BMI (Ganz et al, 2014).…”

A cross-sectional study of impaired glucose tolerance amongst undergraduate medical students

“…Similarly a study by Ganz M, et al found a positive association between BMI and a risk of type-2 diabetes mellitus. 8 In a study by Hopper M, et al significantly higher blood glucose levels were also found in women, high BMI, low fitness, and rapid weight gain groups. 9 But in a study by Higaki Y et al body mass index, the percentage of body fat, and waist-to-hip ratio in the borderline glucose tolerance group did not differ from those in normal glucose tolerance group.…”