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Changes in body mass index following newly diagnosed type 2 diabetes and risk of cardiovascular mortality: A cohort study of 8486 primary-care patients
AstraZeneca AB, Sweden .
Uppsala University, Sweden .
Uppsala University, Sweden .
Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Finspång, Primary Health Care in Finspång.
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2013 (English)In: Diabetes & Metabolism, ISSN 1262-3636, Vol. 39, no 4, 306-313 p.Article in journal (Refereed) Published
Abstract [en]

Aims. - Elevated body mass index (BMI) is associated with an increased risk of type 2 diabetes and cardiovascular disease (CVD). This study explored the association between BMI changes in the first 18 months of newly diagnosed type 2 diabetes and the risk of long-term CVD mortality. less thanbrgreater than less thanbrgreater thanMethods. - A total of 8486 patients with newly diagnosed type 2 diabetes and no previous history of CVD or cancer were identified from 84 primary-care centres in Sweden. During the first year after diagnosis, patients were grouped according to BMI change: Increase, or andgt;= +1 BMI unit; unchanged, or between +1 and-1 BMI unit; and decrease, or andlt;=-1 BMI unit. Associations between BMI change and CVD mortality, defined as death from stroke, myocardial infarction or sudden death, were estimated using adjusted Cox proportional hazards models (NCT 01121315). less thanbrgreater than less thanbrgreater thanResults. - Baseline mean age was 60.0 years and mean BMI was 30.2 kg/m(2). Patients were followed for up to 9 years (median: 4.6 years). During the first 18 months, 53.4% had no change in their BMI, while 32.2% decreased and 14.4% increased. Compared with patients with unchanged BMI, those with an increased BMI had higher risks of CVD mortality (hazard ratio: 1.63, 95% CI: 1.11-2.39) and all-cause mortality (1.33, 1.01-1.76). BMI decreases had no association with these risks compared with unchanged BMI: 1.06 (0.76-1.48) and 1.06 (0.85-1.33), respectively. less thanbrgreater than less thanbrgreater thanConclusion. - Increased BMI within the first 18 months of type 2 diabetes diagnosis was associated with an increased long-term risk of CVD mortality. However, BMI decrease did not lower the long-term risk of mortality.

Place, publisher, year, edition, pages
Keyword [en]
Epidemiology, Type 2 diabetes, Weight control, Cardiovascular disease mortality
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-102093DOI: 10.1016/j.diabet.2013.05.004ISI: 000326356900004OAI: diva2:668387

Funding Agencies|AstraZeneca||

Available from: 2013-11-29 Created: 2013-11-29 Last updated: 2013-11-29

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Östgren, Carl Johan
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Division of Community MedicineFaculty of Health SciencesPrimary Health Care in Finspång
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