Background: Several prospective studies have evaluated the association between body mass index (BMI) and cardiovascular mortality among patients with type 2 diabetes, however, the results are controversial.
Objective: To investigate the association of different BMI distributions with total and cardiovascular mortality among diabetic patients.
Methods: A total of 30534 Ukrainian males and 58909 females with type 2 diabetes from the nationwide population-based diabetes register were included in this study.
Results: During the mean follow-up of 2.7 years, 7804 deaths were recorded, of which 3320 were due to cardiovascular disease. After adjustment for age, smoking and alcohol drinking, the hazard ratios across the five BMI categories (<23, 23-24.9, 25-29.9 [reference group], 30-34.9 and >=35 kg/m2) among diabetic men were 1.57 (95% CI 1.42-1.74), 1.16 (1.05-1.28), 1.0, 1.01 (0.91-1.12) and 1.24 (1.02-1.50) for total mortality, and 1.67 (95% CI 1.42-1.95), 1.30 (1.12-1.51), 1.0, 1.13 (0.96-1.34) and 1.54 (1.16-2.05) for cardiovascular mortality, respectively. The respective hazard ratios among diabetic women were 1.34 (95% CI 1.22-1.47), 1.00 (0.91-1.10), 1.0, 1.04 (0.97-1.12) and 1.27 (1.14-1.41) for total mortality, and 1.36 (95% CI 1.18-1.57), 1.06 (0.92-1.21), 1.0, 1.12 (1.01-1.25) and 1.35 (1.15-1.59) for cardiovascular mortality. Additional adjustment for systolic blood pressure, total cholesterol, history of cardiovascular disease, diabetes treatments and duration of diabetes affected the results only slightly.
Conclusions: The present study indicated a U-shaped association between BMI and total and cardiovascular mortality among diabetic men and women.
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