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Updated: Jan 23, 2026

A Zebrafish Model of Diabetes Mellitus and Metabolic Memory
Published on: February 28, 2013
Longitudinal body mass index exposure-based threshold to prevent mortality for populations with type 2 diabetes
Tingting Hu1, Renzhi Cai2, Yiting Xu1
1Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China.
Abstract:
The long-term body mass index (BMI) threshold to prevent mortality among aging individuals with type 2 diabetes mellitus (T2DM) remains unclear. We quantify BMI exposure using two metrics: the percentage of time BMI above target range (TAR) and the percentage of time BMI within target range (TTR). In a cohort of 3,708 adults aged ≥40 years with T2DM and at least 5 BMI measurements across 4 years, 1,020 deaths occurred during a median 5-year follow-up. Sustained BMI ≥27 kg/m2 (TAR) is positively associated with an increased risk of mortality. Furthermore, longer sustenance of BMI within the range of 18.5-26.9 kg/m2 (TTR) is associated with dose-response survival benefits for all-cause, cardiovascular, and cancer mortality, respectively (all p < 0.05). The association is further validated in the China Health and Retirement Longitudinal Study cohort. These findings support that the threshold for increased mortality risk is sustained exposure to BMI ≥27 kg/m2 in middle-aged and elderly adults with T2DM.
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