Key result
High BMI linked to ~43% higher risk of diabetic kidney disease in type 2 diabetes.
Why the study?
The relationship between different body mass index levels and vascular complications in type 2 diabetes mellitus patients was not well understood.
Does higher body mass index increase the risk of vascular complications in patients with type 2 diabetes mellitus?
Cross-Sectional (n=3,224)
No
Does higher body mass index increase the risk of vascular complications in patients with type 2 diabetes mellitus?
Odds Ratio: 1.426 (95% CI 1.005–2.023)
This study highlights that the relationship between body mass index and diabetic vascular complications is not uniform, with higher BMI increasing risks for kidney and carotid disease, while extreme high or low BMIs associate with peripheral neuropathy and arterial disease.
High BMI was associated with diabetic kidney disease and carotid plaque in type 2 diabetes; leaves open whether weight reduction modifies risk.
AIMS/INTRODUCTION: To investigate the relationship between different body mass index (BMI) levels and vascular complications in type 2 diabetes mellitus patients. MATERIALS AND METHODS: Data were collected from 3,224 individuals with type 2 diabetes mellitus (male/female: 1,635/1,589; age 61.31 ± 11.45 years), using a retrospective case study design. The association of BMI quintiles and diabetes mellitus vascular complications was assessed using multiple logistic regression models adjusting for age, sex, diabetes duration, smoking status, drinking and other confounders, using those with the lowest quintile of BMI as the reference group. RESULTS: With increasing BMI, the detection rate of diabetic peripheral neuropathy and peripheral arterial disease initially decreased and then it increased, whereas the detection rate of diabetic kidney disease and carotid atherosclerotic plaques showed an upward trend; however, diabetic retinopathy was irregular. The odds ratios of diabetic peripheral neuropathy decreased as BMI increased from the 21st percentile to the 80th percentile initially, and increased when BMI was in >80th percentile. The same result was shown in peripheral arterial disease. BMI >80th percentile showed a 1.426-fold risk of diabetic kidney disease and a 1.336 -fold risk of carotid atherosclerotic plaque. CONCLUSIONS: In patients with type 2 diabetes mellitus, the relationship between different BMIs and vascular complications varies. A U-shaped relationship was observed between BMI and diabetic peripheral neuropathy, as well as BMI and peripheral arterial disease. BMI is positively correlated with diabetic kidney disease and carotid atherosclerotic plaque; however, it is not correlated with diabetic retinopathy.
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Zhang et al. (2019) conducted a cross-sectional in Type 2 diabetes mellitus (n=3,224). Body mass index levels vs. Lowest quintile of body mass index (<21.62 kg/m2) was evaluated on Diabetic kidney disease (OR 1.426, 95% CI 1.005-2.023). In patients with type 2 diabetes mellitus, BMI >80th percentile increased the risk of diabetic kidney disease (OR 1.426) and carotid atherosclerotic plaque compared to the lowest quintile.
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