Key result
Increasing BMI correlates with higher 10-year QRISK2 scores, showing a U-shaped association in type 2 diabetes.
Why the study?
The influence of obesity classified by increasing body mass index on cardiovascular risk in Asian Indians with and without diabetes had not been studied.
How does body mass index associate with the 10-year QRISK2 cardiovascular disease risk score in Asian Indians with and without type 2 diabetes?
Cross-Sectional (n=5,897)
How does body mass index associate with the 10-year QRISK2 cardiovascular disease risk score in Asian Indians with and without type 2 diabetes?
In Asian Indians without known CVD, increasing BMI is associated with higher 10-year QRISK2 scores, with a U-shaped association observed in those with type 2 diabetes indicating high cardiovascular risk at both low and high BMI extremes.
Answers are grounded in this paper and cite their sources.
Indicates moderate CVD risk in Asian Indians; extends QRISK2 applicability while leaving BMI associations hypothesis-generating.
Background Recent studies have confirmed that obesity is a major cardiovascular disease (CVD) risk factor. The influence of obesity classified according to increasing body mass index (BMI) in South Asians on cardiovascular risk in Asian Indians with and without diabetes has not been studied. Purpose We analysed data from an urban population-based cross-sectional study in India to determine the association of BMI with 10-year QRISK2 CVD risk score in individuals with and without diabetes. Methods The India Heart Watch (IHW) study is a quantitative, cross-sectional epidemiological study conducted in India with 6,198 participants. The present analysis includes 5,897 individuals (men, 3,265; women, 2,632) without known CVD. Demographic and risk factor details (age, tobacco, blood pressure, fasting glucose, and lipid levels) were available. BMI was grouped into six categories: <20.0, 20.0-22.9, 23.0-24.9, 25.0-26.9, 27.0-29.9, and >30.0 kg/m2. South Asia-specific QRISK-10yr risk was determined using the publicly available calculator. Median (25-75th interquartile intervals) BMI in various categories, and individuals with intermediate (>10.0%) and high risk (>20.0%) were identified. Results Median (IQR) BMI (kg/m2) in the study population was 25.5+4.7, more in diabetes (26.6+4.9) vs without diabetes (25.2+4.6). Median QRISK2-10y (%) was 11.1+12.6 in the overall cohort, more in diabetes (21.9+15.1) vs no diabetes (7.8+9.5). There was a significant correlation (Spearman’s rho) of BMI with QRISK2-10y in the overall cohort (0.138, p<0.01) and group without diabetes (0.131, p<0.01) but not in diabetes (-0.002). Polynomial regression showed a significant association of median QRISK2 score with increasing BMI categories in the overall (R2=0.97) and non-diabetes (R2=0.91) groups, and a U-shaped association in diabetes (R2=0.70) (Figure 1). Significant polynomial association of BMI with increasing QRISK2 in participants in the overall, non-diabetes and diabetes cohorts, respectively, was observed in intermediate risk (R2=0.94, 0.89 and 0.76), and not in high risk (>20%) overall (R2=0.73) and non-diabetes (R2=0.16) groups. A U-shaped association was observed in participants with diabetes (R2=0.70). (Figure). Conclusion There is an incremental association of BMI with 10-year QRISK2 score in Asian Indian populations. The risk is significantly greater in individuals with type 2 diabetes. Polynomial analyses demonstrate a U-shaped association of increasing BMI with median QRISK2 and >20% QRISK2 in type-2 diabetes, implying increased cardiovascular risk at both low and high BMI. Prospective studies are needed to confirm these findings.
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Guptha et al. (2026) conducted a cross-sectional in Cardiovascular disease risk (n=5,897). Body mass index (BMI) vs. Lower BMI categories was evaluated on 10-year QRISK2 CVD risk score (Spearman's rho 0.138, p=<0.01). Increasing body mass index was correlated with higher 10-year QRISK2 scores in the overall cohort, with a U-shaped association in those with type-2 diabetes.
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