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BMI–mortality relationship varies among patients with, without diabetes
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The risk for mortality increased as BMI increased in adult patients without diabetes. However, mortality risk decreased with increased BMI among patients with diabetes, data suggest.
Chandra Jackson, PhD, MS, of the Harvard School of Public Health, and colleagues conducted a large prospective study of 74,710 patients who participated in the National Health Interview Survey from 1997 to 2002. Researchers followed their mortality rates through 2006. Of these patients, 34,805 were identified as never-smokers.
Chandra Jackson
According to data, 26% of never-smokers (mean age, 50.1 years; 43% men) were obese, and 2,035 (5%) self-reported a diagnosis of diabetes.
By 2006, researchers observed 4,355 deaths (754 of 4,750 with diabetes; 3,601 of 69,970 without diabetes) among the total study population. In addition, 1,238 never-smokers (247 of 2,035 with diabetes; 991 of 32,770 without) had died.
They observed a qualitative interaction (P=.002) in which the magnitude and direction of the BMI–mortality relationship depended on diabetes, they wrote.
“This finding was surprising, but it may be due to a commonly observed phenomenon in chronic disease epidemiology called ‘reverse causation’ where a person’s weight at the time of the survey can be affected by their disease if it leads to weight loss and muscle wasting during advanced stages,” Jackson said in a press release. “This apparent obesity paradox that has been observed in the past among individuals with diabetes may actually be due to methodological limitations that can bias these types of studies. From clinical and public health points of view, achieving and maintaining a healthy weight should continue to be recommended for both those with and without diabetes.”
Disclosure: The researchers report no relevant financial disclosures.
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