Although weight management plays a central role in diabetes treatment, the associations between two major anthropometric obesity indicators (i.e., BMI and WC) and severe diabetic complications have not been fully elucidated. Thus, we investigated the relationship between BMI or WC and the risk of severe diabetic complications in patients with DM. Analyzed were 113,336 patients with DM (mean age 52 y, HbA1c 7.2%) without prior treatment-requiring diabetic eye disease (TRDED), dialysis, coronary artery disease (CAD), cerebrovascular disease (CVD), heart failure (HF) or amputation. Patients were divided into 6 categories according to BMI or WC (Table). Risk of diabetic complications was analyzed by a multivariate Cox regression model. High BMI was associated with an increased risk of HF but decreased risk of TRDED and initiation of dialysis. Conversely, low BMI was associated with a reduced risk of CAD but increased risks of initiation of dialysis, CVD and HF. A U-shaped relationship between HF and BMI was observed. Risk of amputation was not significantly associated with BMI and initiation of dialysis. Results for WC were similar to those for BMI. The relationship between BMI or WC and the risk of diabetic complications differed greatly among complications, suggesting that the target weight should be individualized according to complications most likely to occur.
Y. Yaguchi: None. K. Fujihara: None. M.H. Yamada: None. Y. Matsubayashi: None. T. Yamada: None. M. Kitazawa: None. M. Yamamoto: None. S. Kodama: None. H. Sone: Research Support; Novo Nordisk, Astellas Pharma Inc., Kowa Company, Ltd., Kyowa Kirin Co., Ltd., Eisai Inc., Sumitomo Dainippon Pharma Co., Ltd.
