Is there a Benefit to Use Calculated Percent Body Fat or Age- and Gender-adjusted BMI-SDSLMS to Predict Risk Factors for Cardiovascular Disease? A German/Austrian Multicenter DPV-Wiss Analysis on 42 048 Type 2 Diabetic Patients

Scheuing, Nicole; Bayer, Cynthia A.; Best, F; Kerner, W.; Lenk, T; Pfeifer, M.; Ruhl, David A.; Schütt, M.; Siegel, Erhard; Stadler, Marietta; Zeyfang, Andrej; Zimny, Stefan; Holl, Reinhard W.; Initiative, Dpv

doi:10.1055/s-0032-1333243

Cited by 5 publications

(5 citation statements)

References 9 publications

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“…Even though a correlation exists between BMI and body fat (%), classification of individual weight disorders may show discrepancies when body fat analyses were performed [44]. Although divergent results have been demonstrated whether BMI or body fat measurements are more accurate to determine potential outcome prognoses [45], we feel safe to use BMI measurement since it represents the mostly accepted parameter in the current literature analyzing trauma populations [2, 5, 7, 8, 30, 41]. Emphasizing our suggestions of adipokines and adiponectin influencing the inflammatory response in multiple trauma, this aspect could not be proven due to the retrospective design of this study.…”

Section: Discussionmentioning

confidence: 99%

Impact of the Body Mass on Complications and Outcome in Multiple Trauma Patients: What Does the Weight Weigh?

Andruszkow

Veh

Mommsen

et al. 2013

Mediators of Inflammation

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Obesity is known as an independent risk factor for various morbidities. The influence of an increased body mass index (BMI) on morbidity and mortality in critically injured patients has been investigated with conflicting results. To verify the impact of weight disorders in multiple traumatized patients, 586 patients with an injury severity score >16 points treated at a level I trauma center between 2005 and 2011 were differentiated according to the BMI and analyzed regarding morbidity and outcome. Plasma levels of interleukin- (IL-) 6 and C-reactive protein (CRP) were measured during clinical course to evaluate the inflammatory response to the “double hit” of weight disorders and multiple trauma. In brief, obesity was the highest risk factor for development of a multiple organ dysfunction syndrome (MODS) (OR 4.209, 95%-CI 1.515–11.692) besides injury severity (OR 1.054, 95%-CI 1.020–1.089) and APACHE II score (OR 1.059, 95%-CI 1.001–1.121). In obese patients as compared to those with overweight, normal weight, and underweight, the highest levels of CRP were continuously present while increased systemic IL-6 levels were found until day 4. In conclusion, an altered posttraumatic inflammatory response in obese patients seems to determine the risk for multiple organ failure after severe trauma.

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Section: Discussionmentioning

confidence: 99%

Impact of the Body Mass on Complications and Outcome in Multiple Trauma Patients: What Does the Weight Weigh?

Andruszkow

Veh

Mommsen

et al. 2013

Mediators of Inflammation

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“…BMI SD score (BMI-SDS) was calculated using national reference data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) study for patients ,18 years old and from the second German National Nutrition Survey for patients $18 years old as described elsewhere (13,14). Beside current BMI-SDS, lowest BMI-SDS (BMI-SDS min ) documented in DPV was analyzed.…”

Section: Demographics and Ed Characteristicsmentioning

confidence: 99%

Clinical Characteristics and Outcome of 467 Patients With a Clinically Recognized Eating Disorder Identified Among 52,215 Patients With Type 1 Diabetes: A Multicenter German/Austrian Study

et al. 2014

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OBJECTIVETo compare clinical characteristics and outcome of type 1 diabetes mellitus (T1DM) between patients with and without a clinically recognized eating disorder (ED). RESEARCH DESIGN AND METHODSA total of 52,215 T1DM patients aged 8 to <30 years from the prospective diabetes data acquisition system DPV were analyzed. A total of 467 patients had an additional diagnosis of ED according to DSM-IV criteria (anorexia nervosa [AN], n = 141 [female: 94.3%]; bulimia nervosa [BN], n = 62 [90.3%]; and EDs not otherwise specified, including binge-eating disorder [EDNOS], n = 264 [74.2%]). Groups were compared using multivariable regression. Cox proportional hazard ratios were calculated for the association between ED and retinopathy. RESULTSAfter adjustment for age, sex, and duration of diabetes, patients with ED revealed higher HbA 1c (no ED vs. AN, BN, or EDNOS, respectively: 8.29 6 0.01% [67.1 6 0.1 mmol/mol] vs. 8.61 6 0.15% [70.6 6 1.6 mmol/mol], 9.11 6 0.23% [76.1 6 2.5 mmol/mol], or 9.00 6 0.11% [74.9 6 1.2 mmol/mol]) and a higher rate of pathological insulin injection sites (48.4 vs. 64.3, 64.1, or 62.1%). Furthermore, ketoacidosis (5.7 6 0.1 vs. 12.1 6 2.1, 18.0 6 4.1, or 12.9 6 1.6 events per 100 person-years) and hospitalization (54.9 6 0.3 vs. 89.3 6 6.0, 132.0 6 12.7, or 91.0 6 4.4 per 100 person-years) were more common, and duration of hospital stay was longer (4.81 6 0.01 vs. 11.31 6 0.21, 18.05 6 0.48, or 8.44 6 0.13 days per year). All P values were <0.05. Patients with BN and EDNOS had a 2.5-fold (95% CI 1.3-4.8) and a 1.4-fold (0.8-2.3) higher risk for retinopathy, whereas AN patients had no increased risk (0.9 [95% CI 0.4-2.3]). CONCLUSIONSDiabetes health care professionals should be aware of comorbid EDs in pediatric/ young-adult T1DM patients. An ED diagnosis is associated with worse metabolic control and higher rates of diabetes complications.

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“…The DPV represents a prospective and multicenter diabetes patient registry [ 14 ]. Each center locally documents diabetes-related data.…”

Section: Methodsmentioning

confidence: 99%

“…The body mass index (BMI) corresponds to the body weight in kilograms divided by square of the height in meters (kg/m 2 ). As the BMI varies also in adulthood, the age and gender adjusted BMI-SDS by Hemmelmann et al was calculated based on individual BMI and age- and gender-dependent reference values [ 14 , 15 ]. Reference values of the Second German National Nutrition Survey were used [ 15 ].…”

Section: Methodsmentioning

confidence: 99%

Psoriasis and Diabetes: A Multicenter Study in 222078 Type 2 Diabetes Patients Reveals High Levels of Depression

Schwandt

Bergis

Dapp³

et al. 2015

Journal of Diabetes Research

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Objective. This study aimed to investigate the association between psoriasis and disease outcome in type 2 diabetes (T2D). Methods. 222078 T2D patients (≥10 years old) from the prospective, multicenter diabetes patient registry were analyzed. Specific search items were used to identify psoriasis patients. Multiple regression models were fitted and adjusted for demographic confounder. Results. 232 T2D patients had comorbid psoriasis. After adjusting psoriasis patients revealed a higher BMI (31.8 [31.0; 32.6] versus 30.6 [30.5; 30.6] kg/m2, p = 0.004) and HbA1c (64.8 [62.1; 67.6] versus 59.0 [58.9; 59.1] mmol/mol, p < 0.0001). Insulin was used more frequently (62.3 [55.7; 68.5] versus 50.9 [50.7; 51.1] %, p = 0.001), only OAD/GLP-1 was similar, and nonpharmacological treatment was less common (13.3 [9.5; 18.3] versus 21.9 [21.7; 22.1] %, p = 0.002). Severe hypoglycemia (0.31 [0.238; 0.399] versus 0.06 [0.057; 0.060] events per patient-year, p < 0.0001), hypertension (86.1 [81.1; 90.0] versus 68.0 [67.8; 68.2] %, p < 0.0001), and thyroid disease (14.0 [10.1; 19.2] versus 4.6 [4.5; 4.7] %, p < 0.0001) were more prevalent. Depression occurred more often (10.5 [7.1; 15.2] versus 2.8 [2.7; 2.8] %, p < 0.0001). Conclusions. Clinical diabetes characteristics in psoriasis T2D patients were clearly worse compared to patients without psoriasis. Comorbid conditions and depression were more prevalent, and more intensive diabetes therapy was required.

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Is there a Benefit to Use Calculated Percent Body Fat or Age- and Gender-adjusted BMI-SDSLMS to Predict Risk Factors for Cardiovascular Disease? A German/Austrian Multicenter DPV-Wiss Analysis on 42 048 Type 2 Diabetic Patients

Abstract: Compared to Body Mass Index, age- and gender-adjusted Body Mass Index Standard Deviation Score, or calculation of %body fat, has no further benefit to predict cardiovascular disease risk factors in adult type 2 diabetic patients.

Cited by 5 publications

References 9 publications

Impact of the Body Mass on Complications and Outcome in Multiple Trauma Patients: What Does the Weight Weigh?

Impact of the Body Mass on Complications and Outcome in Multiple Trauma Patients: What Does the Weight Weigh?

Clinical Characteristics and Outcome of 467 Patients With a Clinically Recognized Eating Disorder Identified Among 52,215 Patients With Type 1 Diabetes: A Multicenter German/Austrian Study

Psoriasis and Diabetes: A Multicenter Study in 222078 Type 2 Diabetes Patients Reveals High Levels of Depression

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