Obesity and weight loss are inversely related to mortality and cardiovascular outcome in prediabetes and type 2 diabetes: data from the ORIGIN trial
Why the study?
The association of body weight and weight change with mortality and cardiovascular outcomes in patients with diabetes mellitus is not clearly established.
Does BMI category or weight loss impact mortality and cardiovascular outcomes in patients with prediabetes or type 2 diabetes and established CV risk factors?
Population
12 521 ORIGIN trial participants with established CV risk factors and type 2 DM or pre-diabetes
Comparison
Different BMI categories and weight change vs normal BMI and no weight loss
Design
Post-hoc analysis of a randomized trial
Follow-up
6.2 years (interquartile range 5.8-6.7 years)
Authors
Discussion
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Member takes
Implication
Weight loss may signal higher risk in DM with CV factors; leaves open whether intentional reduction affects outcomes.
Structured PICO
Does BMI category or weight loss impact mortality and cardiovascular outcomes in patients with prediabetes or type 2 diabetes and established CV risk factors?
P
Population
12,521 patients with established cardiovascular risk factors and type 2 diabetes mellitus or pre-diabetes from the ORIGIN trial
I
Intervention
Overweight (BMI 25-29.9 kg/m2), obesity Grades 1-3 (BMI ≥30 kg/m2), low body weight (BMI <22 kg/m2), and continued 2-year weight loss
C
Comparator
Normal BMI (22-24.9 kg/m2) and no weight loss
O
Outcome
Total and cardiovascular mortality, and composite outcomes of CV death, non-fatal stroke, or myocardial infarction plus revascularization or heart failure hospitalizationhard clinical
In patients with diabetes or pre-diabetes and cardiovascular risk factors, overweight and moderate obesity are associated with lower mortality, while weight loss is associated with higher mortality, demonstrating an obesity paradox.
Cite This Study
Doehner et al. (2020) studied this question.