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Body Mass Index and Type 2 Diabetes Risk

Incremental association among those with higher body mass indexes…. 

In this case-control study, researchers assessed the association between body mass index and the risk of being diagnosed with type 2 diabetes. Researchers further assessed the incremental impact of increased body mass index based upon body mass index categories.

Overweight was defined as having a body mass index between 25 and 29.9; Obesity Class I as a body mass index between 30 and 34.9; Obesity Class II as a body mass index ranging from 35 and 39.9 and Obesity Class III as a body mass index of ≥40.

Odds ratios and relative risks were estimated from multiple logistic regression results.

Individuals in the control group were selected based upon age, sex, history of cardiac comorbidities or hyper-inflammatory state (defined by C-reactive protein and erythrocyte sedimentation rate), and use of psychiatric or beta-blocker medications.

BMI was measured 1 year prior to the first observed type 2 diabetes diagnosis and for those in the control group, body mass index was obtained from a randomly assigned date.

A total of 12,179 cases were included in the analysis (average age 55, 43% male) along with 25,177 controls (average age 56, 55% female). A positive association between body mass index and the risk of a type 2 diabetes diagnosis was found. This association strength increased based upon body mass index category as followings: Overweight individuals (RR=1.5, CI 95%, 1.4 to 1.6); Obesity Class I (RR=2.5, CI 95%, 2.3 to 2.6) Obesity Class II (RR=3.6, CI 95%, 3.4 to 3.8); Obesity Class III (RR=5.1, CI 95% 4.7 to 5.5).

In this large cohort, body mass index was found to not only be strongly and independently associated with the risk of being diagnosed with type 2 diabetes but also the magnitude of this positive association is significantly larger for higher BMI values.

Practice Pearls:
  • Body mass index is a strong and independent risk factor for being diagnosed with type 2 diabetes mellitus
  • Type 2 diabetes risk may be incrementally higher in those with a higher body mass index
  • Understanding the risk factors helps to shorten the time to diagnosis and treatment

Ganz ML, Wintfeld N, Li Q, Alas V, Langer J, Hammer M. 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. Diabetol Metab Syndr. 2014;6(1):50. http://www.dmsjournal.com/content/6/1/50