Weight loss mitigates risks for microvascular complications
Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...
Studies suggest decreased mortality risk among people who are overweight or obese compared with individuals with normal weight in type 2 diabetes (obesity paradox). However, the relationship between body weight or weight change and microvascular vs macrovascular complications of type 2 diabetes remains unresolved. Researchers investigated the association between BMI and BMI change with long-term risk of microvascular and macrovascular complications in type 2 diabetes in a prospective cohort study.

Researchers studied participants with incident type 2 diabetes from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam cohort, who were free of cancer, cardiovascular disease and microvascular disease at diagnosis (n?=?1083). Pre-diagnosis BMI and relative annual change between pre- and post-diagnosis BMI were evaluated in multivariable-adjusted Cox models.

Results:
-- There were 85 macrovascular (myocardial infarction and stroke) and 347 microvascular events (kidney disease, neuropathy and retinopathy) over a median follow-up of 10.8 years.

-- Median pre-diagnosis BMI was 29.9 kg/m2 and the median relative annual BMI change was ?0.4%.

-- Higher pre-diagnosis BMI was positively associated with total microvascular complications, kidney disease and neuropathy but not with macrovascular complications.

-- Analyses according to BMI categories corroborated these findings.

-- Effect modification was not evident by sex, smoking status or age groups.

-- In analyses according to BMI change categories, BMI loss of more than 1% indicated a decreased risk of total microvascular complications, kidney disease and neuropathy, compared with participants with a stable BMI; no clear association was observed for macrovascular complications.

-- The associations between BMI gain compared with stable BMI and diabetes-related vascular complications were less apparent.

-- Associations were consistent across strata of sex, age, pre-diagnosis BMI or medication but appeared to be stronger among never-smokers compared with current or former smokers.

Conclusively, among people with incident type 2 diabetes, pre-diagnosis BMI was positively associated with microvascular complications, while a reduced risk was observed with weight loss when compared with stable weight. The relationships with macrovascular disease were less clear.

Source:
Like
Comment
Share