The association of body mass index with the risk of type 2 diabetes: a case-control study nested in an electronic health records system in the United States.
The association of body mass index with the risk of type 2 diabetes: a case-control study nested in an electronic health records system in the United States.
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DOI：
10.1186/1758-5996-6-50
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发表时间：
2014-04-03
影响因子：
4.8
通讯作者：
Hammer M
中科院分区：
文献类型：
--
作者：
Ganz ML;Wintfeld N;Li Q;Alas V;Langer J;Hammer M
肥胖是2型糖尿病（T2D）的一个已知危险因素。我们在美国进行了一项病例对照研究，以评估体重指数（BMI）与被诊断为T2D的风险之间的关系。我们选择了2004年1月至2011年10月期间被诊断为T2D（由ICD-9-CM诊断代码定义或使用抗糖尿病药物定义）的成年人（≥18岁）（“病例”），这些病例来自中大西洋地区综合卫生系统提供的电子健康记录数据库。在研究期间，根据年龄、性别、心脏合并症史或高炎症状态（由c反应蛋白和红细胞沉降率定义）以及使用精神或受体阻滞剂药物选择了两倍于卫生系统登记的无T2D诊断的个体（“对照组”）。在首次观察到T2D诊断前一年测量BMI（对于病例）或随机指定日期（对于对照组）；没有BMI测量或BMI < 18.5 kg/m2的个体被排除。我们评估了相对于正常BMI (18.5-24.9 kg/m2)， BMI增加（超重：25-29.9 kg/m2；肥胖I级：30-34.9 kg/m2；肥胖II级：35-39.9 kg/m2；肥胖III级：≥40 kg/m2）对t2dm诊断的影响，使用了多重logistic回归结果估计的比值比（OR）和相对风险（RR）。我们纳入了12,179例（平均年龄：55岁，男性43%）和25,177例对照（平均年龄：56岁，男性45%）。我们发现BMI和患t2dm的风险呈正相关。这种关联强度随着BMI类别的增加而增加（RR[95%可信区间]：超重，1.5[1.4-1.6]；肥胖I类，2.5[2.3-2.6]；肥胖II类，3.6[3.4-3.8]；肥胖III类，5.1[4.7-5.5]）。BMI与被诊断为T2D的风险有很强且独立的相关性。相对于BMI较低的人群而言，BMI类别与T2D风险的增量关联在BMI较高的人群中更为明显。
Obesity is a known risk factor for type 2 diabetes (T2D). We conducted a case–control study to assess the association between body mass index (BMI) and the risk of being diagnosed with T2D in the United States. We selected adults (≥ 18 years old) who were diagnosed with T2D (defined by ICD-9-CM diagnosis codes or use of anti-diabetic medications) between January 2004 and October 2011 (“cases”) from an electronic health records database provided by an integrated health system in the Middle Atlantic region. Twice as many individuals enrolled in the health system without a T2D diagnosis during the study period (“controls”) were selected based on age, sex, history of cardiac comorbidities or hyperinflammatory state (defined by C-reactive protein and erythrocyte sedimentation rate), and use of psychiatric or beta blocker medications. BMI was measured during one year prior to the first observed T2D diagnosis (for cases) or a randomly assigned date (for controls); individuals with no BMI measure or BMI < 18.5 kg/m2 were excluded. We assessed the impact of increased BMI (overweight: 25–29.9 kg/m2; Obesity Class I: 30–34.9 kg/m2; Obesity Class II: 35–39.9 kg/m2; Obesity Class III: ≥40 kg/m2), relative to normal BMI (18.5–24.9 kg/m2), on a T2D diagnosis using odds ratios (OR) and relative risks (RR) estimated from multiple logistic regression results. We included 12,179 cases (mean age: 55, 43% male) and 25,177 controls (mean age: 56, 45% male). We found a positive association between BMI and the risk of a T2D diagnosis. The strength of this association increased with BMI category (RR [95% confidence interval]: overweight, 1.5 [1.4–1.6]; Obesity Class I, 2.5 [2.3–2.6]; Obesity Class II, 3.6 [3.4–3.8]; Obesity Class III, 5.1 [4.7–5.5]). BMI is strongly and independently associated with the risk of being diagnosed with T2D. The incremental association of BMI category on the risk of T2D is stronger for people with a higher BMI relative to people with a lower BMI.
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影响因子：
158.5
作者：
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