The risk of type 2 diabetes mellitus according to the categories of body mass index: the Korean Genome and Epidemiology Study (KoGES)
Obesity is an established risk factor for type 2 diabetes mellitus (T2DM). However, there is limited information on the pattern of relationship between the risk for T2DM and body mass index (BMI) categories including underweight and overweight. Thus, this study was to evaluate the risk of T2DM according to BMI categories defined by Asian-specific cutoff of BMI.
7660 non-diabetic Koreans were grouped into five BMI categories (underweight, normal, overweight, obese and severe obese) defined by Asian-specific cutoff of BMI and followed up for 10 years to monitor the development of T2DM. With a reference of normal BMI group, Cox proportional hazards assumption was used to calculate hazard ratios (HRs) and their 95% confidence intervals for T2DM in five groups. Subgroup analysis was conducted by gender and age (40–59 years and 60–69 years).
Baseline mean value of metabolic factors like fasting glucose, HOMA-IR, total cholesterol and the proportion of impaired fasting glucose increased proportionally to the level of BMI categories. Underweight group had the higher proportion of impaired glucose tolerance than normal and overweight group. In all subgroups, underweight, overweight, obese and severe obese group had the higher HRs for T2DM than normal group, but statistical significance was only found in overweight, obese and severe obese group.
The risk of T2DM tends to increase proportionally to the level of BMI categories from overweight to severe obese group. Further studies should be considered to identify the incidental relationship between underweight and T2DM.
KeywordsBody mass index Underweight Obesity and type 2 diabetes mellitus
Data in this study were from the Korean Genome and Epidemiology Study (KoGES; 4851-302), National Research Institute of Health, Centers for Disease Control and Prevention, Ministry for Health and Welfare, Republic of Korea. Therefore, this study could be done by virtue of the labor of all staffs working in KoGES.
Ju Young Jung coordinated the study, analyzed the data and wrote the manuscript as a first author. Chang-Mo Oh played role in analyzing data and verifying the results. Jae-Hong Ryoo participated in conducting study and writing manuscript. Joong-Myung Choi participated in English editing and reviewing manuscript. Young-Jun Choi has a role in monitoring study process and making manuscript. Sung Keun Park is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Compliance with ethical standards
Conflict of interest
Nothing to be declared. The authors report no relationships that could be construed as a conflict of interest.
Human and animal rights
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.
Informed consent was obtained from all patients for being included in the study.
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