Body mass index and stroke risk among patients with type 2 diabetes mellitus
Weiqin Li1, Peter T Katzmarzyk1, Ronald Horswell1
1From the Pennington Biomedical Research Center, Baton Rouge, LA (W.L., P.T.K., R.H., Y.Z., W.Z., Y.W., G.H.); Tianjin Women's and Children's Health Center, Tianjin, China (W.L.); China Japan Friendship Hospital, Beijing, China (W.Z.); and Louisiana State University Health, Baton Rouge (J.J.).
Background And Purpose:
Previous studies have evaluated the association of body mass index (BMI) with the risk of all-cause and cardiovascular disease mortality among diabetic patients, and results were controversial. No studies have focused on the association between BMI and stroke risk among diabetic patients. We aimed to examine the association of BMI with stroke risk among diabetic patients.
Methods:
We performed a prospective cohort study with 29,554 patients with type 2 diabetes mellitus. Cox proportional hazards regression models were used to estimate the association of different levels of BMI with stroke risk.
Results:
During a mean follow-up period of 8.3 years, 2883 participants developed stroke (2821 ischemic and 109 hemorrhagic). The multivariable-adjusted (age, sex, race, smoking, income, and type of insurance) hazard ratios associated with different levels of BMI at baseline (18.5-24.9 [reference group], 25-29.9, 30-34.9, 35-39.9, and ≥40 kg/m(2)) were 1.00, 0.86, 0.83, 0.76, and 0.70 (Ptrend<0.001) for total stroke, 1.00, 0.87, 0.85, 0.78, and 0.72 (Ptrend <0.001) for ischemic stroke, and 1.00, 0.76, 0.72, 0.54, and 0.53 (Ptrend=0.034) for hemorrhagic stroke, respectively. When we used an updated mean or the last visit value of BMI, the inverse association of BMI with stroke risk did not change. This inverse association was consistent among patients of different races, sex, ages, HbA1c levels, never and current smoking, and patients with and without using glucose-lowering, cholesterol-lowering, or antihypertensive agents.
Conclusions:
The present study demonstrates an inverse association between BMI and stroke risk among patients with type 2 diabetes mellitus.
Related Concept Videos
01:22Diabetes Mellitus: Type 2 and Gestational
01:36Carbohydrate Metabolism
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in...
01:24Type II Diabetes II: Pathophysiology
01:25Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis
01:26Type II Diabetes I: Introduction
01:22Diabetes Mellitus: Overview and Type I Subtype
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...