Exploring the non-linear association between BMI and mortality in adults with and without diabetes: the US National Health Interview Survey

Wang, Z., Dong, B., Hu, J., Adegbjija, O and Arnold, LW (2016) Exploring the non-linear association between BMI and mortality in adults with and without diabetes: the US National Health Interview Survey. Diabetic Medicine, 33 12: 1691-1699. doi:10.1111/dme.13111


Author Wang, Z.
Dong, B.
Hu, J.
Adegbjija, O
Arnold, LW
Title Exploring the non-linear association between BMI and mortality in adults with and without diabetes: the US National Health Interview Survey
Journal name Diabetic Medicine   Check publisher's open access policy
ISSN 1464-5491
0742-3071
Publication date 2016-03-30
Year available 2016
Sub-type Article (original research)
DOI 10.1111/dme.13111
Open Access Status Not Open Access
Volume 33
Issue 12
Start page 1691
End page 1699
Total pages 9
Place of publication Chichester, West Sussex, United Kingdom
Publisher Wiley-Blackwell Publishing
Language eng
Subject 2724 Internal Medicine
2712 Endocrinology, Diabetes and Metabolism
1310 Endocrinology
Abstract AimsTo assess the non-linear relationship between BMI and mortality and to determine the BMI values with the lowest mortality risk in adults with and without diabetes.
Formatted abstract
Aims
To assess the non-linear relationship between BMI and mortality and to determine the BMI values with the lowest mortality risk in adults with and without diabetes.

Methods
This observational study assessed the relationship between BMI and mortality with flexible parametric survival models using data from the US National Health Interview Survey. Participants included 25 458 adults with diabetes and 315 939 adults without diabetes, aged 18–84 years at baseline surveys, conducted from 1997 to 2009. Mortality status data were obtained from the linked mortality data up to 2011.

Results
We observed a U-shaped relationship between BMI and mortality in both adults with and without diabetes. With the BMI 25–29.9 kg/m2 group as reference, hazard ratios (95% CI) of mortality for those with BMI < 18.5, 18.5–24.9, 30–34.9, 35–39.9 and ≥ 40 kg/m2 were 2.67 (2.12, 3.35), 1.26 (1.18, 1.35), 1.04 (0.98, 1.12), 1.12 (1.02, 1.22) and 1.37 (1.24, 1.51), respectively, for adults with diabetes, adjusting for age, sex, race and survey year. The corresponding hazard ratios for adults without diabetes were 2.97 (2.78, 3.17), 1.27 (1.23, 1.30), 1.07 (1.03, 1.12), 1.36 (1.27, 1.45), and 1.77 (1.62, 1.92), respectively. The BMI values associated with the lowest mortality were 29.1 kg/m2 for adults with diabetes and 26.7 kg/m2 for those without diabetes.

Conclusions
Regardless of the presence of diabetes, there is a U-shaped relationship between BMI and mortality. The BMI values associated with the lowest mortality were above the current ‘normal’ range for adults with and without diabetes.
Keyword Endocrinology & Metabolism
Endocrinology & Metabolism
Q-Index Code C1
Q-Index Status Provisional Code
Grant ID APP1042343
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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Created: Mon, 14 Mar 2016, 18:46:33 EST by Zhiqiang Wang on behalf of Medicine - Royal Brisbane and Women's Hospital