The Relationship between Body Mass Index and Incident Diabetes Mellitus in Chinese Aged Population: A Cohort Study

Abstract

Objectives. Previous studies reported that overweight older adults had a lower mortality after cardiovascular diseases attack, indicating being thinner might not always be better. However, there is an ongoing debate about what is the optimal range of body mass index (BMI) for the aged population. We aimed to evaluate the value of BMI for the prediction of incident diabetes mellitus (DM) in the Chinese elderly population. Methods. A total number of 6,911 Chinese elderly people (4,110 men and 2,801 women, aged 71 ± 6.0 years) were included in this cohort study. BMI was measured at baseline (Jan 1, 2014, to Dec 31, 2014). All the participants were further classified into six groups: <18.5 kg/m2, 18.5 to <22.5 kg/m2, 22.5 to <25.0 kg/m2, 25.0 to <27.5 kg/m2, 27.5 to <30.0 kg/m2, and ≥30.0 kg/m2. Fasting blood glucose (FBG) and glycated hemoglobin A1c (HbA1c) were annually measured during follow-up (Jan 1, 2015-May 31, 2019). DM was confirmed if either FBG ≥ 7.0 mmol / L or HbA 1 c ≥ 6.5 % . We used the Cox proportional hazard regression model to evaluate the association between BMI and the prediction of incident DM. Results. Comparing individuals with a BMI range of 18.5 to <22.5 kg/m2 (reference), the hazard ratio for incident DM was 2.13 (95% CI: 1.54~2.95), 2.14 (95% CI: 1.53~3.00), 3.17 (95% CI: 2.19~4.59), 3.15 (95% CI: 1.94~5.09), and 3.14 (95% CI: 1.94~5.09) for the group with a BMI range of 22.5 to <25.0 kg/m2, 25.0 to <27.5 kg/m2, 27.5 to <30.0 kg/m2, and ≥30.0 kg/m2 after adjusting for baseline age, sex, blood pressure, lipid profiles, and eGFR ( P trend < 0.001), after adjusting for the abovementioned confounders. The association tended to be closer in men and young participants, compared with their counterparts. Conclusions. High BMI was associated with a high risk of developing DM in the Chinese aged population. Thus, it is optimal for the aged population to maintain their body weight within a reasonable range to prevent chronic diseases.

Association of body mass index with risk of prediabetes in Chinese adults: A population‐based cohort study

“… 5 , they found that when BMI was approximately 22 kg/m 2 , the HR of diabetes risk of the elderly in China was approximately 1, while similar results were obtained in the study of Tang et al . 36 , the cut‐off value of BMI measured by them was approximately 22.4 kg/m 2 . These studies point out that BMI is a powerful indicator for assessing the risk of diabetes and provide potential BMI intervention thresholds for different populations.…”

“…Several studies have been carried out in the Chinese population specifically to assess the optimal BMI range or cut‐off value for predicting the risk of diabetes 33 , 34 , 35 , 36 . It is important to note that the analytical methods and conclusions used in these studies are not identical; in addition, similar to the findings of the present study, the association between BMI and diabetes does not follow the pattern of the obesity paradox.…”

“…The result suggested that the best cut‐off points for predicting diabetes in young men and women in China were 25.5 kg/m 2 and 24.4 kg/m 2 , whereas those in middle‐aged men and women were 23.5 kg/m 2 and 23.0 kg/m 2 . Additionally, two recent studies have specially assessed the optimal BMI range for predicting diabetes risk in the Chinese elderly population through the RCS with 3 knots and 5 knots, respectively 35,36 . In the study of Hu et al 5 ,.…”

Higher body mass index was associated with better prognosis in diabetic patients with stage II colorectal cancer

“…Higher BMI could increase the risk of CRC [ 18 , 19 ], and BMI might have an impact on the outcomes and prognosis of CRC surgery [ 20 ]. BMI was also related to T2DM and metabolic diseases [ 21 , 22 ]. Therefore, it is necessary to analyze the exact effect of BMI on diabetic patients with CRC.…”

“…In this study, we found that the ratio of hypertension and CHD was higher in the higher BMI group compared with the lower BMI group. The probable reason was that BMI was associated with metabolic and cardiovascular diseases [ 21 , 22 ]. However, there was no difference between the two groups in terms of surgical outcomes.…”