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Epidemiology/Health Services Research

BMI and Coronary Heart Disease Risk Among Low-Income and Underinsured Diabetic Patients

  1. Nan Li1,2,
  2. Peter T. Katzmarzyk1,
  3. Ronald Horswell1,
  4. Yonggang Zhang1,
  5. Weiqin Li1,2,
  6. Wenhui Zhao1,
  7. Yujie Wang1,
  8. Jolene Johnson3 and
  9. Gang Hu1⇑
  1. 1Pennington Biomedical Research Center, Baton Rouge, LA
  2. 2Tianjin Women’s and Children’s Health Center, Tianjin, China
  3. 3Louisiana State University Health, Baton Rouge, LA
  1. Corresponding author: Gang Hu, gang.hu{at}pbrc.edu.
Diabetes Care 2014 Dec; 37(12): 3204-3212. https://doi.org/10.2337/dc14-1091
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Abstract

OBJECTIVE The association between obesity and coronary heart disease (CHD) risk remains debatable, and no studies have assessed this association among diabetic patients. The aim of our study was to investigate the association between BMI and CHD risk among patients with type 2 diabetes.

RESEARCH DESIGN AND METHODS The sample included 30,434 diabetic patients (10,955 men and 19,479 women) 30–95 years of age without a history of CHD or stroke in the Louisiana State University Hospital-Based Longitudinal Study.

RESULTS During a mean follow-up period of 7.3 years, 7,414 subjects developed CHD. The multivariable-adjusted hazard ratios for CHD across levels of BMI at baseline (18.5–24.9, 25–29.9, 30–34.9, 35–39.9, and ≥40 kg/m2) were 1.00, 1.14 (95% CI 1.00–1.29), 1.27 (1.12–1.45), 1.54 (1.34–1.78), and 1.42 (1.23–1.64) (Ptrend < 0.001) in men and 1.00, 0.95 (0.85–1.07), 0.95 (0.84–1.06), 1.06 (0.94–1.20), and 1.09 (1.00–1.22) (Ptrend < 0.001) in women, respectively. When we used an updated mean or last visit value of BMI, the positive association between BMI and CHD risk did not change in men. However, the positive association of BMI with CHD changed to a U-shaped association in women when we used the last visit value of BMI.

CONCLUSIONS Our study suggests that there is a positive association between BMI at baseline and during follow-up with the risk of CHD among patients with type 2 diabetes. We indicate a U-shaped association between BMI at the last visit and the risk of CHD among women with type 2 diabetes.

  • Received April 30, 2014.
  • Accepted August 25, 2014.
  • © 2014 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.
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Diabetes Care: 37 (12)

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December 2014, 37(12)
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BMI and Coronary Heart Disease Risk Among Low-Income and Underinsured Diabetic Patients
Nan Li, Peter T. Katzmarzyk, Ronald Horswell, Yonggang Zhang, Weiqin Li, Wenhui Zhao, Yujie Wang, Jolene Johnson, Gang Hu
Diabetes Care Dec 2014, 37 (12) 3204-3212; DOI: 10.2337/dc14-1091

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BMI and Coronary Heart Disease Risk Among Low-Income and Underinsured Diabetic Patients
Nan Li, Peter T. Katzmarzyk, Ronald Horswell, Yonggang Zhang, Weiqin Li, Wenhui Zhao, Yujie Wang, Jolene Johnson, Gang Hu
Diabetes Care Dec 2014, 37 (12) 3204-3212; DOI: 10.2337/dc14-1091
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