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Association between Obesity and Microvascular Diseases in Patients with Type 2 Diabetes Mellitus
26 Pages Posted: 2 Oct 2020
More...Abstract
Background: The association between obesity and microvascular diseases, especially in extremely obese patients with type 2 diabetes mellitus, has not been well examined. This study aimed to investigate this association and further compare the magnitude of the associations of fat mass index (FMI), body mass index (BMI), waist circumference (WC), and waist-to-height (W-t-H), with the risk of microvascular diseases in type 2 diabetes mellites(T2DM).
Methods: We mainly used FMI as an indicator of obesity to study the association with microvascular diseases and performed a post hoc analysis of the ACCORD study. The primary microvascular outcomes of the present study included severe renal hypofunction, retinopathy, or neuropathy.
Findings: After confounding factors were adjusted for, patients with the highest quartile of FMI had a higher risk of severe renal hypofunction (hazard ratio [HR]: 1·26, 95% confidence interval [CI]: 1·16–1·36) and neuropathy (HR: 1·93, 95% CI: 1·74–2·15) but not higher risk of retinopathy (HR: 1·17, 95% CI: 0·96–1·43) than those with the lowest quartile. A “plateau phenomenon” for severe renal hypofunction and neuropathy was found when the extent of obesity exceeded a certain point. Quartiles, deciles or standardized measure (1-SD increment) of obesity indicators analysis showed inconsistent results on which obesity indicator had a stronger association with the risk of microvascular disease.
Interpretation: Obesity is associated with renal function deterioration and neuropathy but not with retinopathy. Compared to BMI, WC, and W-t-H, FMI did not show a stronger association with the risk of microvascular diseases.
Funding Statement: None.
Declaration of Interests: All authors declare to have no conflict of interest.
Keywords: Type 2 diabetes mellitus, microvascular diseases, obesity
Suggested Citation: Suggested Citation