Cited by 567Diabetes, Cardiovascular Risks, and LipoproteinsObesity, Physical Activity, DietCardiovascular Function and Risk Factors

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Association of Weight Status With Mortality in Adults With Incident Diabetes

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Carnethon, Mercedes R., De Chavez, Peter John D., Biggs, Mary L., Lewis, Cora E., Pankow, James S., Bertoni, Alain G., Golden, Sherita H., Liu, Kiang, Mukamal, Kenneth J., Campbell-Jenkins, Brenda, Dyer, Alan R.·2012·JAMA

DOI 10.1001/jama.2012.9282PMC PMC3467944

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Abstract

CONTEXT: Type 2 diabetes in normal-weight adults (body mass index [BMI] <25) is a representation of the metabolically obese normal-weight phenotype with unknown mortality consequences. OBJECTIVE: To test the association of weight status with mortality in adults with new-onset diabetes in order to minimize the influence of diabetes duration and voluntary weight loss on mortality. DESIGN, SETTING, AND PARTICIPANTS: Pooled analysis of 5 longitudinal cohort studies: Atherosclerosis Risk in Communities study, 1990-2006; Cardiovascular Health Study, 1992-2008; Coronary Artery Risk Development in Young Adults, 1987-2011; Framingham Offspring Study, 1979-2007; and Multi-Ethnic Study of Atherosclerosis, 2002-2011. A total of 2625 participants with incident diabetes contributed 27,125 person-years of follow-up. Included were men and women (age >40 years) who developed incident diabetes based on fasting glucose 126 mg/dL or greater or newly initiated diabetes medication and who had concurrent measurements of BMI. Participants were classified as normal weight if their BMI was 18.5 to 24.99 or overweight/obese if BMI was 25 or greater. MAIN OUTCOME MEASURES: Total, cardiovascular, and noncardiovascular mortality. RESULTS: The proportion of adults who were normal weight at the time of incident diabetes ranged from 9% to 21% (overall 12%). During follow-up, 449 participants died: 178 from cardiovascular causes and 253 from noncardiovascular causes (18 were not classified). The rates of total, cardiovascular, and noncardiovascular mortality were higher in normal-weight participants (284.8, 99.8, and 198.1 per 10,000 person-years, respectively) than in overweight/obese participants (152.1, 67.8, and 87.9 per 10,000 person-years, respectively). After adjustment for demographic characteristics and blood pressure, lipid levels, waist circumference, and smoking status, hazard ratios comparing normal-weight participants with overweight/obese participants for total, cardiovascular, and noncardiovascular mortality were 2.08 (95% CI, 1.52-2.85), 1.52 (95% CI, 0.89-2.58), and 2.32 (95% CI, 1.55-3.48), respectively. CONCLUSION: Adults who were normal weight at the time of incident diabetes had higher mortality than adults who are overweight or obese.

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Authors: Carnethon, M. R., De Chavez, P. J. D., Biggs, M. L., Lewis, C. E., Pankow, J. S., Bertoni, A. G., Golden, S. H., Liu, K., Mukamal, K. J., Campbell-Jenkins, B., & Dyer, A. R.
Affiliations: Northwestern University (US)
University of Washington (US)
University of Alabama (US)
University of Minnesota (US)
Wake Forest University Health Sciences (US)
Johns Hopkins University (US)
Beth Israel Deaconess Medical Center (US)
Corresponding author: Carnethon, Mercedes R.
ORCID: Carnethon, Mercedes R.
Lewis, Cora E.
Pankow, James S.
Bertoni, Alain G.
Golden, Sherita H.
Liu, Kiang
Mukamal, Kenneth J.
Dyer, Alan R.
Venue: JAMA
Publisher: American Medical Association (AMA)
Published: 2012-08-08
Volume: 308
Issue: 6
Pages: 581-90
ISSN: 0002-9955 (ISSN-L)
0098-7484
DOI: 10.1001/jama.2012.9282
PMC: PMC3467944
OpenAlex: W2040767736
Cited by: 567
References: 36
Citations by year: 2026: 16 · 2025: 18 · 2024: 32 · 2023: 36 · 2022: 26 · 2021: 31 · 2020: 38 · 2019: 36 · 2018: 47 · 2017: 41 · 2016: 54 · 2015: 45 · 2014: 70 · 2013: 59 · 2012: 16
FWCI: 48.78
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: JAMA (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institutes of Health (n01hc95095-66-0-1, n01hc95164-17-0-1, n01hc085082-026, n01hc085081-021, n01hc045133-001, n01hc48050-59-0-1, n01hc085079-024, n01hc015103-009, n01hc48048-58-0-1, n01hc085084-005, n01hc55021-47-0-1, n01hc085085-011, n01hc085083-027, n01hc95165-34-0-1, n01hc48047-55-0-1, n01hc55020-39-0-0, n01hc085080-026, n01hc55016-37-0-0, n01hc055022-024, n01hc95161-24-0-1, n01hc095169-003, n01hc085086-022, n01hc48049-61-0-1, n01hc95162-31-0-1, n01hc55019-35-0-1, n01hc95160-18-0-1, n01hc55018-38-0-1, n01hc95163-22-0-1, n01hc55222-0-0-0, n01hc95159-40-0-1, n01hc075150-004, n01hc035129-010, n01hc55015-48-0-1)
National Institute on Aging (AG 20098, R56AG023629, R01AG020098, AG023629, AG027058, R56AG020098, R01AG023629, R01AG015928, R01AG027058)
National Heart, Lung, and Blood Institute (N01-HC-85081, N01HC85085, N01-HC55022, N01 HC085086, N01HC48050, N01HC-85083, N01 HC-95159, N01-HC-95160, N01 HC055016, N01-HC-55018, N01-HC095169, N01-HC-095165, N0-1-HC-85239, N01 HC 95095, N01 HC 55020, N01 HC085079, (N01-HC-95163, N01 HC 55019, N01HC85082, N01HC‐75150, N01 HC85086, N01 HC-95161, N01 HC95165, N01HC95164, N01 HC048048, N01 HC055020, N01 HC035129, N01-HC-048049, N01HC85080, N01-HC-095159, N01 HC055018, N01 HC015103, N01 HC095095, N01 HC55222, N01 HC048050, N01-HC48048, N01-HC55016, N01 HC055022, N01-HC-48-049, U01HL080295, N01 HC055019, N01 HC055222, N01 HC048047, N01-HC-480-47, HL080295, R01HL080295, N01‐HC‐55015, N01 HC-95162, N01-HC55021, N01 HC075150, N01 HC055021, N01 HC055015, N01 HC045133, R01HL078972, N01-HC85079, N01-HC85084, N01 HC95169)
National Institute of Diabetes and Digestive and Kidney Diseases (P30DK079637, R21DK082903)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
Keywords: type 2 diabetes, normal-weight individuals, body mass index, weight status, mortality, cardiovascular mortality, non-cardiovascular mortality, new-onset diabetes, overweight and obesity, diabetes duration, weight loss, cardiovascular risk factors, sex differences, racial and ethnic differences, socioeconomic status, alcohol consumption, physical activity
MeSH terms: Adult, Aged, Aged, 80 and over, Body Weight, Cardiovascular Diseases, Cause of Death, Diabetes Mellitus, Type 2, Female, Humans, Longitudinal Studies, Male, Middle Aged, Obesity, United States, Body Mass Index, Overweight

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Association of Weight Status With Mortality in Adults With Incident Diabetes

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