Baseline and longitudinal trajectories of body-mass index and all-cause mortality among patients with type 2 diabetes

Aim: To investigate the associations of baseline body mass index (BMI) and longitudinal BMI trajectories with all-cause mortality among patients with type 2 diabetes mellitus (T2DM).Methods,: We used data from the diabetes surveillance system of Yinzhou Health Information System with T2DM patients registered from 2010 to 2015. Participants aged >= 40 years were included and were followed up until September 30, 2021. The latent class growth mixture model was used to identify different changing patterns in BMI for 5 years from registration. Cox proportional hazards models were used to examine the associations of baseline BMI and 5-year BMI trajectories with all-cause mortality.Results: We observed a nonlinear association between baseline BMI and all-cause mortality (P for nonlinear-ity < 0.001), with an increased risk of death for low but not high BMI. However, compared with participants with medium-stable BMI for 5 years from baseline, individuals with increasing BMI had higher mortality, with adjusted hazard ratios (95% confidence intervals) 1.21 (1.02;1.43) for early-increasing and 1.47 (1.19;1.80) for late-sharp increasing groups.Conclusion: These findings suggest that while obesity itself may not be associated with an increased risk for mortality, weight gain, and in particular rapid weight gain, is a risk factor for mortality among patients with T2DM.(c) 2023 Elsevier Masson SAS. All rights reserved.

Automated summary

The aim of this study was to investigate the associations between baseline body mass index (BMI), longitudinal BMI trajectories, and all-cause mortality in patients with type 2 diabetes mellitus (T2DM). The findings showed that individuals with increasing BMI had higher mortality rates, indicating that rapid weight gain is a risk factor for mortality among T2DM patients.