Relationship between a single measurement at baseline of body mass index, glycated hemoglobin, and the risk of mortality and cardiovascular morbidity in type 2 diabetes mellitus

Brown, O., Costanzo, P., Clark, A. L., Condorelli, G., Cleland, J. G.F. , Sathyapalan, T., Hepburn, D., Kilpatrick, E. S. and Atkin, S. L. (2020) Relationship between a single measurement at baseline of body mass index, glycated hemoglobin, and the risk of mortality and cardiovascular morbidity in type 2 diabetes mellitus. Cardiovascular Endocrinology and Metabolism, 9(4), pp. 177-182. (doi: 10.1097/XCE.0000000000000202) (PMID:33225234) (PMCID:PMC7673766)

Abstract

Objective: This study aims to evaluate the relationship between a single measurement at baseline of body mass index (BMI), glycated hemoglobin (HbA1c) and subsequent clinical outcomes in patients with type 2 diabetes mellitus (T2DM). Method: Patients with T2DM were recruited from an outpatient diabetes clinic in a single large teaching hospital in Kingston upon Hull, UK. At baseline, demographics and HbA1c were recorded. Patients were categorized by BMI: normal weight (18.5–24.9 kg/m2), overweight (25–29.9 kg/m2), and obese (>30 kg/m2). Multivariable Cox regression models that included demographic, risk factors, and comorbidities were separately constructed for all-cause, cardiovascular, cancer and sepsis-related mortality, using four groups of HbA1c (<6%, 6.0–6.9%, 7.0–7.9%, and >8%). Results: In total, 6220 patients with T2DM (median age 62 years, 54% male) were followed for a median of 10.6 years. HbA1c levels >8.0% were associated with increased risk of all-cause mortality and cardiovascular death. However, this increased risk was not consistent across the weight categories and reached statistical significance only in overweight patients (BMI 25–29.9 kg/m2). Conclusions: In a large cohort of patients with T2DM elevated HbA1c levels at baseline did not consistently predict increased risk of all-cause and cardiovascular mortality across the different BMI categories.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Cleland, Professor John
• Authors: Brown, O., Costanzo, P., Clark, A. L., Condorelli, G., Cleland, J. G.F., Sathyapalan, T., Hepburn, D., Kilpatrick, E. S., and Atkin, S. L.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
• Journal Name: Cardiovascular Endocrinology and Metabolism
• Publisher: Lippincott, Williams and Wilkins
• ISSN: 2574-0954
• ISSN (Online): 2574-0954
• Published Online: 25 May 2020
• Copyright Holders: Copyright © 2020 Wolters Kluwer Health, Inc.
• First Published: First published in Cardiovascular Endocrinology and Metabolism 9(4): 177-182
• Publisher Policy: Reproduced in accordance with the publisher copyright policy