Relation between BMI and diabetes mellitus and its complications among US older adults.
Relation between BMI and diabetes mellitus and its complications among US older adults.
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DOI：
10.14423/smj.0000000000000214
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发表时间：
2015-01
影响因子：
1.1
通讯作者：
Yashkin A
中科院分区：
文献类型：
--
作者：
Gray N;Picone G;Sloan F;Yashkin A
本研究旨在确定体重指数（BMI）升高对美国老年人2型糖尿病（DM）发病及其并发症的影响。数据来自1991-2010年医疗保险当前受益人调查（MCBS）。采用考克斯比例风险模型评估首次MCBS访视时BMI升高对既往无DM诊断且未参加Medicare Advantage的Medicare受益人（N= 14，657）的DM诊断、并发症和胰岛素依赖发作的影响。在DM诊断的个体中，BMI升高与不良结局的风险逐渐升高相关。对于女性，胰岛素依赖的风险比（HR）范围为1.77（25 ≤ BMI ≤ 27.49）至3.57（BMI ≥ 40）。在心血管（HR=1.34至HR=2.45）、脑血管（HR=1.30至HR=2.00）、肾脏（HR= 1.31至HR=2.23）和下肢并发症（HR=1.41至HR=2.95）的风险中观察到相似的模式。在男性中，糖尿病并发症的风险增加发生在较高的BMI（27.5 ≤ BMI ≤ 29.99）水平比女性。在两种性别中，眼部并发症发生在BMI水平高于其他并发症类型。即使BMI适度升高，也会增加发生DM并发症的风险。
This study determines effects of elevated body mass index (BMI) on type 2 diabetes mellitus (DM) onset and its complications among U.S. elderly. Data came from the Medicare Current Beneficiary Survey (MCBS), 1991-2010. A Cox proportional hazard model was used to assess effects of elevated BMI at the first MCBS interview on DM diagnosis, complications, and insulin dependence onset among Medicare beneficiaries with no prior DM diagnosis and not enrolled in Medicare Advantage (N=14,657). Among DM-diagnosed individuals, elevated BMIs were associated with progressively higher risk of adverse outcomes. For women, hazard ratio (HR) of insulin dependence ranged from a 1.77 at 25 ≤ BMI ≤ 27.49 to 3.57 at BMI ≥ 40. A similar pattern was observed in risk for cardiovascular (HR=1.34 to HR=2.45), cerebrovascular (HR=1.30 to HR=2.00), renal (HR=1.31 to HR=2.23), and lower extremity complications (HR=1.41 to HR=2.95). In men, increased risks for DM complications occurred at higher BMI (27.5 ≤ BMI ≤ 29.99) levels than in women. Ocular complications occurred at higher BMI levels than other complication types in both genders. Having even moderately elevated BMI is associated with increased risk of developing DM complications.