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La asociación del estado de peso con la mortalidad en adultos con diabetes incidente
Mercedes R Carnethon1, Peter John D De Chavez, Mary L Biggs
1Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Dr, Ste 1400, Chicago, IL 60611, USA. carnethon@northwestern.edu
JAMA
|August 9, 2012
Resumen
Los adultos de peso normal con diabetes tipo 2 de nueva aparición enfrentan mayores riesgos de mortalidad. Este estudio encontró que las personas con un índice de masa corporal (IMC) normal experimentaron un aumento de la mortalidad total, cardiovascular y no cardiovascular en comparación con sus contrapartes con sobrepeso u obesidad.
Área de la Ciencia:
- Endocrinología y Metabolismo.
- Epidemiología La epidemiología.
- Salud Pública La salud pública.
Sus antecedentes:
- La diabetes tipo 2 en adultos de peso normal, denominada fenotipo de peso normal metabólicamente obeso, tiene implicaciones de mortalidad poco claras.
- Comprender las consecuencias de la mortalidad del estado de peso en el diagnóstico de diabetes es crucial para el manejo clínico y las estrategias de salud pública.
Objetivo del estudio:
- Investigar la asociación entre el estado de peso y la mortalidad en adultos recién diagnosticados con diabetes tipo 2.
- Minimizar los factores de confusión como la duración de la diabetes y la pérdida de peso intencional al centrarse en los casos de diabetes incidentes.
Principales métodos:
- Análisis combinado de cinco grandes estudios longitudinales de cohorte que incluyeron a más de 2600 participantes con diabetes incidente.
- Los participantes fueron clasificados como de peso normal (IMC 18.5-24.99) o con sobrepeso/obesidad (IMC ≥25) en el momento del diagnóstico de diabetes.
- Los resultados de la mortalidad (total, cardiovascular, no cardiovascular) fueron seguidos durante un período de seguimiento mediano.
Principales resultados:
- Los individuos de peso normal constituían aproximadamente el 12% de los adultos con diabetes incidente.
- Las tasas de mortalidad por causas totales, cardiovasculares y no cardiovasculares fueron significativamente más altas en los participantes de peso normal en comparación con los participantes con sobrepeso / obesidad.
- Los ratios de riesgo ajustados indicaron un riesgo sustancialmente mayor de mortalidad total y no cardiovascular para individuos de peso normal con diabetes incidente.
Conclusiones:
- El peso normal en el momento del diagnóstico de diabetes tipo 2 se asocia con un aumento de la mortalidad por todas las causas y por causas específicas.
- Los hallazgos destacan que el peso normal no confiere protección contra resultados adversos de mortalidad en personas con diabetes.
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