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2型糖尿病患者体重指数相关死亡率及肥胖悖论研究中的异质性：剂量反应荟萃分析

Body Mass Index-Related Mortality in Patients with Type 2 Diabetes and Heterogeneity in Obesity Paradox Studies: A Dose-Response Meta-Analysis.

作者信息

Kwon Yeongkeun, Kim Hyun Jung, Park Sungsoo, Park Yong-Gyu, Cho Kyung-Hwan

机构信息

Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea.

Center for Obesity and Metabolic Diseases, Korea University Anam Hospital, Seoul, South Korea.

出版信息

PLoS One. 2017 Jan 3;12(1):e0168247. doi: 10.1371/journal.pone.0168247. eCollection 2017.

DOI:10.1371/journal.pone.0168247
PMID:28046128
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5207428/
Abstract

OBJECTIVE

We conducted a systematic review and meta-analysis of studies to quantify the association between body mass index (BMI) and the risks of all-cause and cardiovascular mortality in patients with type 2 diabetes.

METHODS

We included studies assessing the impact of BMI on all-cause and cardiovascular mortality in patients with type 2 diabetes. Data were combined using a random-effects dose-response model.

RESULTS

Sixteen cohort studies on all-cause mortality (n = 445,125) and two studies on cardiovascular mortality (n = 92,841) were evaluated in the meta-analysis. A non-linear association was observed between BMI and all-cause mortality among patients with type 2 diabetes. With a BMI nadir of 28-30 kg/m2, the risk of all-cause mortality displayed a U-shaped increase. With a BMI nadir of 29-31 kg/m2, the risk of cardiovascular mortality exhibited a gradual non-linear increase for BMI > 31 kg/m2. Subgroup analyses suggested that study location, diabetes duration, and smoking history may have contributed to heterogeneity among the studies.

CONCLUSIONS

An obesity paradox exists for patients with type 2 diabetes with respect to all-cause and cardiovascular mortality. Study location, diabetes duration, and smoking history might contribute to heterogeneity among obesity paradox studies of patients with type 2 diabetes.

摘要

目的

我们对相关研究进行了系统评价和荟萃分析，以量化体重指数（BMI）与2型糖尿病患者全因死亡率和心血管死亡率风险之间的关联。

方法

我们纳入了评估BMI对2型糖尿病患者全因死亡率和心血管死亡率影响的研究。数据采用随机效应剂量反应模型进行合并。

结果

荟萃分析评估了16项关于全因死亡率的队列研究（n = 445,125）和2项关于心血管死亡率的研究（n = 92,841）。在2型糖尿病患者中，观察到BMI与全因死亡率之间存在非线性关联。BMI最低点为28 - 30 kg/m²时，全因死亡率风险呈U形增加。BMI最低点为29 - 31 kg/m²时，BMI > 31 kg/m²时心血管死亡率风险呈逐渐非线性增加。亚组分析表明，研究地点、糖尿病病程和吸烟史可能导致了研究之间的异质性。

结论

2型糖尿病患者在全因死亡率和心血管死亡率方面存在肥胖悖论。研究地点、糖尿病病程和吸烟史可能导致2型糖尿病患者肥胖悖论研究之间的异质性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0db/5207428/f8f31fc142cf/pone.0168247.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0db/5207428/85d3d3cd5ae7/pone.0168247.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0db/5207428/3d571aa9535e/pone.0168247.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0db/5207428/f8f31fc142cf/pone.0168247.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0db/5207428/85d3d3cd5ae7/pone.0168247.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0db/5207428/3d571aa9535e/pone.0168247.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0db/5207428/f8f31fc142cf/pone.0168247.g003.jpg

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