Maximum body mass index before onset of type 2 diabetes is independently associated with advanced diabetic complications.

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  • Additional Information
    • Source:
      Publisher: Published by BMJ in partnership with the American Diabetes Association Country of Publication: England NLM ID: 101641391 Publication Model: Print Cited Medium: Internet ISSN: 2052-4897 (Electronic) Linking ISSN: 20524897 NLM ISO Abbreviation: BMJ Open Diabetes Res Care Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : Published by BMJ in partnership with the American Diabetes Association
    • Subject Terms:
      Diabetes Mellitus, Type 2*/complications ; Diabetes Mellitus, Type 2*/diagnosis ; Diabetes Mellitus, Type 2*/epidemiology ; Diabetic Nephropathies*/diagnosis ; Diabetic Nephropathies*/epidemiology ; Diabetic Nephropathies*/etiology ; Diabetic Retinopathy*/diagnosis ; Diabetic Retinopathy*/epidemiology ; Diabetic Retinopathy*/etiology; Body Mass Index ; Cross-Sectional Studies ; Humans
    • Abstract:
      Introduction: The maximum body mass index (BMI) before onset of type 2 diabetes (MBBO) might be used to estimate a patient's insulin secretion capacity. There have been few factors that can predict future diabetic complications at the time of diagnosis of diabetes mellitus. This study aimed to clarify the clinical usefulness of MBBO for predicting the development of advanced diabetic microvascular complications.
      Research Design and Methods: This was a cross-sectional observational study. Of 1304 consecutively admitted patients with type 2 diabetes, we enrolled 435 patients for whom we could confirm their MBBO. Univariate and multivariate logistic regression analyses were performed to examine whether MBBO or BMI on admission was associated with advanced diabetic retinopathy or nephropathy. To evaluate the predictive performance of these indexes, we performed cross-validation in various models with MBBO or BMI and evaluated the areas under the curve (AUCs) yielded by these analyses.
      Results: Univariate analyses suggested that MBBO was associated with advanced retinopathy and nephropathy, while BMI on admission was associated only with advanced nephropathy. In multivariate analyses, MBBO was significantly associated with advanced complications, while BMI on admission was not. For advanced diabetic retinopathy, the AUCs were 0.70-0.72, and for advanced nephropathy, the AUCs were 0.81-0.83. When comparing the AUCs among models, the models with MBBO sustained high predictive performance for diabetic complications.
      Conclusions: MBBO was independently associated with advanced diabetic complications, while BMI on admission was not. Diabetic microvascular complications in patients with high MBBO could progress more rapidly. At the time of the diagnosis of diabetes mellitus, MBBO would enable us to predict the progress of diabetic complications.
      Competing Interests: Competing interests: None declared.
      (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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    • Contributed Indexing:
      Keywords: clinical study; diabetes complications; diabetes mellitus; obesity; type 2
    • Publication Date:
      Date Created: 20211225 Date Completed: 20211230 Latest Revision: 20231108
    • Publication Date:
      20231215
    • Accession Number:
      PMC8710853
    • Accession Number:
      10.1136/bmjdrc-2021-002466
    • Accession Number:
      34952840