Weight change is associated with increased all-cause mortality and non-cardiac mortality among patients with type 2 diabetes mellitus

Xing, Zhenhua; Pei, Junyu; Huang, Jinbo; Peng, Xiaofan; Chen, Pengfei; Hu, Xinqun; Gao, Shan

doi:10.1007/s12020-019-01892-2

Cited by 17 publications

(17 citation statements)

References 32 publications

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“…Our previous study also found that the average change in weight across the entire study was 1.80%, representing 0.448 kg/m 2 ; therefore, any change in WC is likely relatively small [49]. Second, all included patients were Caucasians, and these results may not apply to other populations (e.g., an Asian population) that exhibit different habits.…”

Section: Discussionmentioning

confidence: 90%

Waist circumference is associated with major adverse cardiovascular events in male but not female patients with type-2 diabetes mellitus

Xing

Peng

Wang

et al. 2020

Cardiovasc Diabetol

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Background: Although studies have shown that waist circumference (WC) is positively associated with an increased risk of cardiovascular diseases among the normal population, few studies have investigated WC in patients with type-2 diabetes mellitus (T2DM). Methods: This was a post hoc analysis of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study. The Cox proportional hazards models was used to investigate the relationship between WC and major adverse cardiovascular events (MACEs) in T2DM patients with cardiovascular disease (CVD) or high risk factors of CVD. Results: A total of 10,251 T2DM patients (6299 men [61.4%], 3952 women [38.6%]) were included in our analysis. The mean age was 64.0 ± 7.53 years. After a mean follow-up at 9.2 ± 2.4 years later, 1804 patients (event rate of 23 per 1000 person-years) had developed MACEs. MACEs rates in men and women were 18.0 and 26.0 events per 1000 person-years, respectively. After multivariable adjustment, each increase in WC of 1 SD increased the risk of MACEs (HR: 1.10, 95% CI 1.04-1.17; P < 0.01) in men, with a non-significant increase in MACEs (HR: 1.04, 95% CI 0.95-1.13; P = 0.40) in women. Compared with those in the first quartile of WC, male patients in the fourth quartile of WC had a hazard ratio (HR) of 1.24 (95% CI 1.05-1.46) for MACEs; female patients in the fourth quartile of WC had an HR of 1.22 (95% CI 0.96-1.56) for MACEs. Conclusions: Higher WC is associated with increased risks of MACEs in male but not female T2DM patients.

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Section: Discussionmentioning

confidence: 90%

Waist circumference is associated with major adverse cardiovascular events in male but not female patients with type-2 diabetes mellitus

Xing

Peng

Wang

et al. 2020

Cardiovasc Diabetol

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“…Weight loss occurring soon after diabetes diagnosis may be representative of intentional weight loss, motivated by the recent diagnosis. However, other research has shown null or inverse associations between weight loss and CVD among people with diabetes 3–5 . Long‐term weight loss or weight loss later in the course of diabetes, particularly among older adults, may not be protective against complications, as this may be indicative of unintentional weight loss due to illness or frailty, which is more common among people with diabetes 6 …”

Section: Introductionmentioning

confidence: 99%

“…However, other research has shown null or inverse associations between weight loss and CVD among people with diabetes. [3][4][5] Longterm weight loss or weight loss later in the course of diabetes, particularly among older adults, may not be protective against complications, as this may be indicative of unintentional weight loss due to illness or frailty, which is more common among people with diabetes. 6 The effects of intentional weight loss achieved through behavioural intervention programmes on CVD remain unclear.…”

Section: Introductionmentioning

confidence: 99%

Association of weight loss and weight loss maintenance following diabetes diagnosis by screening and incidence of cardiovascular disease and all‐cause mortality: An observational analysis of the ADDITION‐Europe trial

Strelitz

Sharp

Khunti

et al. 2020

Diabetes Obesity Metabolism

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Aims Short‐term weight loss may lead to remission of type 2 diabetes but the effect of maintained weight loss on cardiovascular disease (CVD) is unknown. We quantified the associations between changes in weight 5 years following a diagnosis of diabetes, and incident CVD events and mortality up to 10 years after diagnosis. Materials and methods Observational analysis of the ADDITION‐Europe trial of 2730 adults with screen‐detected type 2 diabetes from the UK, Denmark and the Netherlands. We defined weight change based on the maintenance at 5 years of weight loss achieved during the year after diabetes diagnosis, and as 5‐year overall change in weight. Incident CVD events (n = 229) and all‐cause mortality (n = 225) from 5 to 10 years follow‐up were ascertained from medical records. Results Gaining >2% weight during the year after diabetes diagnosis was associated with higher hazard of all‐cause mortality versus maintaining weight [hazard ratio (95% confidence interval): 3.18 (1.30‐7.82)]. Losing ≥5% weight 1 year after diagnosis was also associated with mortality, whether or not weight loss was maintained at 5 years: 2.47 (0.99‐6.21) and 2.72 (1.17‐6.30), respectively. Losing ≥10% weight over 5 years was associated with mortality among those with body mass index <30 kg/m2 [4.62 (1.87‐11.42)]. Associations with CVD incidence were inconclusive. Conclusions Both weight loss and weight gain after screen‐detected diabetes diagnosis were associated with higher mortality, but not CVD events, particularly among participants without obesity. The clinical implications of weight loss following a diagnosis of diabetes probably depend on its magnitude and timing, and may differ by body mass index status. Personalization of weight loss advice and support may be warranted.

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“…Moreover, results from other studies were not statistically significant for the association of weight loss with CVD [17][18][19]. Similar to weight loss, findings for the effect of weight gain on CVD events were inconclusive among populations with T2DM, in which adverse [16,20], protective [15], and neutral [18,19] effects have been reported for weight gain all together.…”

Section: Introductionmentioning

confidence: 83%

“…Data from the ORIGIN trial and the Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen-Detected Diabetes in Primary Care (ADDITION)-Cambridge trial showed significant protection for weight loss among participants with T2DM [14,15]; however, the Action in Diabetes and Vascular disease: preterAx and diamicroN-MR Controlled Evaluation (ADVANCE) trial showed a significantly increased risk of CVD among participants with weight loss [16]. Moreover, results from other studies were not statistically significant for the association of weight loss with CVD [17][18][19]. Similar to weight loss, findings for the effect of weight gain on CVD events were inconclusive among populations with T2DM, in which adverse [16,20], protective [15], and neutral [18,19] effects have been reported for weight gain all together.…”

Section: Introductionmentioning

confidence: 97%

Weight change and risk of cardiovascular disease among adults with type 2 diabetes: more than 14 years of follow-up in the Tehran Lipid and Glucose Study

Moazzeni

Arani

Deravi

et al. 2021

Cardiovasc Diabetol

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Background To examine the impact of weight change on incident cardiovascular disease and coronary heart disease (CVD/CHD) among an Iranian population with type 2 diabetes mellitus (T2DM). Methods The study population included 763 participants with T2DM aged ≥ 30 years without a history of CVD and cancer at baseline. Two weight measurements done at baseline and about 3 years later. Based on their weight change, they categorized into: > 5% loss, 3–5% loss, stable (± < 3%), 3–5% gain, > 5% gain. Participants were then followed for incident CVD/CHD annually up to 20 March 2018. Multivariable Cox proportional hazard models, adjusted for age, sex, body mass index, educational level, current smoking, glucose-lowering drug use, family history of CVD, hypertension, hypercholesterolemia, chronic kidney disease, and fasting plasma glucose (FPG) were applied to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of weight change categories for incident CVD/CHD, considering stable weight as reference. Results After the weight change measurement, during a median follow-up of 14.4 years, 258 CVD and 214 CHD occurred. Over 5% weight gain was associated with reduced risks of CVD and CHD development by the HRs of 0.70 [95% CI 0.48–1.01; P-value: 0.058] and 0.61 [0.40–0.93], respectively, in multivariable analysis. After further adjustment for FPG change, the HRs of weight gain > 5% were attenuated to 0.75 [0.51–1.10; P-value: 0.138] and 0.66 [043–1.01; P-value: 0.053] for incident CVD and CHD, respectively. The effect of weight loss > 5% was in opposite direction among those older versus younger than 60 years; with suggestive increased risk (not statistically significant) of incident CHD/CVD for the older group. Moreover, weight gain > 5% significantly reduced the risk of CHD only among those older than 60 years (P-value for interaction < 0.2). Furthermore, weight gain > 5% had an association with lower risk of CVD and CHD among sulfonylurea users (0.56 [0.32–0.98] for CVD and 0.54 [0.29–0.99] for CHD). Conclusions Our results with a long-term follow-up showed that weight gain > 5% was associated with better CVD/CHD outcomes among Iranian participants with T2DM, especially older ones. Moreover, we did not find an unfavorable impact on incident CVD/CHD for sulfonylurea-induced weight gain.

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Weight change is associated with increased all-cause mortality and non-cardiac mortality among patients with type 2 diabetes mellitus

Cited by 17 publications

References 32 publications

Waist circumference is associated with major adverse cardiovascular events in male but not female patients with type-2 diabetes mellitus

Waist circumference is associated with major adverse cardiovascular events in male but not female patients with type-2 diabetes mellitus

Association of weight loss and weight loss maintenance following diabetes diagnosis by screening and incidence of cardiovascular disease and all‐cause mortality: An observational analysis of the ADDITION‐Europe trial

Weight change and risk of cardiovascular disease among adults with type 2 diabetes: more than 14 years of follow-up in the Tehran Lipid and Glucose Study

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