Objective: Body weight (BW) reduction is recommended for improvement of metabolic control in obese patients with type 2 diabetes (T2D). However, it is not fully understood to what extent of BW reduction is sufficient in Japanese. The aim of the study was to assess the impact of BW change on glycemic control and lipid profiles in obese Japanese patients with T2D.
Methods: The study subjects were 684 patients (65% men, mean age 59 years) with a body mass index (BMI) ≥25 kg/m2 among 8,179 patients with T2D who visited our diabetes clinic in both 2013 and 2015-2016. The changes in the levels for casual blood glucose (CBG), HbA1c, serum lipids, BW and proportions of patients taking medications (oral hypoglycemic agents and injection) between baseline and follow-up periods were determined. The liner regression analysis was performed to assess the relation of the changes in BW and changes in CPG, HbA1c, and serum lipid profiles. ANOVA and ANCOVA were used to compare these changes across five groups classified by the changes in BW as <-3% (n=195), -3 to -1% (n=138), -1 to 1% (n=126), 1 to 3% (n=78), and ≥3% (n=146).
Results: During the observational period, median values for BMI, CPG, HbA1c, triglyceride (TG), and LDL-cholesterol (LDL-C) were significantly decreased and HDL-C was significantly increased (all p<0.01). Changes in medications were observed in 72% of the patients. Multivariable liner regression analysis showed significant relations between the changes in BW and the changes in TG (beta=0.12, p<0.01) and LDL-C (beta =0.081, p=0.04). The adjusted mean change in TG in the five groups classified by the changes in BW were -7.8, 1.4, 6.8, 11.2, and 17.5%, and significant difference was found between the groups of BW <-3 and ≥3%. There was no difference in change in other parameters across the five groups.
Conclusion: In obese Japanese patients with T2D, change in BW was closely associated with change in TG and LDL-C, with statistically significant change in TG in those exhibiting -3% decrease in BW.
R. Yoshimura: None. Y. Hasegawa: None. T. Nakagami: None. T. Babazono: None.