Highlights
- •In a Spanish cohort of T2DM outpatients, mortality rate is 26.38/per 1000 patient-years.
- •In males, the BMI value showing the highest all-cause mortality is <23 kg/m2.
- •Higher BMIs are not associated with higher mortality rates in either males or females.
Abstract
Purpose
To analyse the association between body mass index (BMI) and all-cause mortality in
a 5-year follow-up study with Spanish type 2 diabetes mellitus (T2DM) patients, seeking
gender differences.
Methods
3443 T2DM outpatients were studied. At baseline and annually, patients were subjected
to anamnesis, a physical examination, and biochemical tests. Data about demographic
and clinical characteristics was also recorded, as was the treatment each patient
had been prescribed. Mortality records were obtained from the Spanish National Institute
of Statistics. Survival curves for BMI categories (Gehan-Wilcoxon test) and a multivariate
Cox proportional hazard analysis were performed to identify adjusted Hazard Ratios
(HRs) of mortality.
Results
Mortality rate was 26.38 cases per 1000 patient-years (95% CI, 23.92–29.01), with higher rates in men (28.43 per 1000 patient-years; 95% CI, 24.87–32.36) than in women (24.31 per 1000 patient-years; 95% CI, 21.02–27.98) (p = 0.079). Mortality rates according to BMI categories were: 56.7 (95% CI, 40.8–76.6),
28.4 (95% CI, 22.9–34.9), 24.8 (95% CI, 21.5–28.5), 21 (95% CI, 16.3–26.6) and 23.7
(95% CI, 14.3–37) per 1000 person-years for participants with a BMI of <23, 23–26.8, 26.9–33.1, 33.2–39.4, and >39.4 kg/m2, respectively. The BMI values associated with the highest all-cause mortality were
<23 kg/m2, but only in males [HR: 2.78 (95% CI, 1.72–4.49; p < 0.001)], since in females this association was not significant [HR: 1.14 (95% CI,
0.64–2.04; p = 0.666)] (reference category for BMI: 23.0–26.8 kg/m2). Higher BMIs were not associated with higher mortality rates.
Conclusions
In an outpatient T2DM Mediterranean population sample, low BMI predicted all-cause
mortality only in males.
Keywords
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Article info
Publication history
Published online: July 02, 2017
Accepted:
June 21,
2017
Received in revised form:
June 18,
2017
Received:
December 14,
2016
Identification
Copyright
© 2017 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
