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Obesity paradox on the survival of elderly patients with diabetes: an AHAP-based study

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Abstract

Background and objectives

Overweight and obesity are among the important challenges in health issues and survival of elderly people. The current study aimed to evaluate the survival rate of elderly patients with diabetes, and its influencing factors, on the basis of body mass index (BMI).

Methods and materials

The design of the current study was based on the Amirkola Health and Aging Project (AHAP) cohort. The 5–year survival rate of elderly people with diabetes and the factors that influence the mortality rate by Cox regression model were analyzed.

Results

Out of 1616 elderly people who were evaluated in the current study, 501 (31%) had diabetes. The results showed that diabetes significantly increased the mortality rate (adjusted hazard ratio [HR] = 2.10; 95% confidence interval [CI]: 1.57–2.81; P < 0.001). Furthermore, overweight (HR = 0.41; 95%CI: 0.24–0.75; P = 0.002), obesity (HR = 0.30; 95% CI: 0.41–0.63; P = 0.002), history of diabetes (HR = 0.56; 95%CI: 0.34–0.93; P = 0.024), moderate and high physical activity level (HR = 0.36; 95%CI: 0.13–0.99; P = 0.049) decreased the risk of mortality and central obesity (HR = 1.76; 95% CI: 1.01–3.11; P = 0.049), fasting blood sugar ≥200 (HR = 2.46; 95% CI: 1.46–4.15; P < 0.001), brain stroke, and neurological diseases (HR = 3.12; 95% CI: 1.78–5.49; P < 0.001) increased the risk of mortality.

Conclusion

Although overweight and obesity significantly improved the risk of mortality in elderly patients with diabetes, central obesity is still considered as an important risk factor.

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Abbreviations

AHAP :

amirkola health and ageing project

BMI :

body mass index

CI :

confidence interval

CPH :

cox proportional hazard

CVA :

cerebrovascular accident

DM :

diabetes mellitus

DSSI :

duke social support index

FBS :

fasting blood sugar

GDS :

geriatric depression scale

IDF :

international diabetes federation

PASE :

physical activity scale for elderly

WC :

waist circumference

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Acknowledgements

The authors would like to thank all authorities of Babol University of Medical Sciences,

AHAP collaboration and the elderly participants of this project.

Funding

This study has been financially supported by the Research and Technology Deputy of Babol University of Medical Sciences with grant number 9440021.

Author information

Authors and Affiliations

  1. Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran

    Ali Bijani, Seyed-Reza Hosseini & Reza Ghadimi

  2. School of Public Health, University of Sydney, Sydney, Australia

    Robert G. Cumming

  3. Health Research Institute, Babol University of Medical Sciences, Babol, Iran

    Masoumeh Yazdanpour, Mahdis Rahimi & Abbas Sahebian

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  1. Ali Bijani
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Contributions

AB, SRH, RC and RG conceived and designed the study. AB, MY, RR and AS gathered the data. AB performed the statistical analysis. AB drafted the manuscript. SRH and RG critically revised the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Seyed-Reza Hosseini.

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Competing interests

The authors declare that they have no competing interests.

Ethics approval and consent to participate

Our study was reviewed and approved by ethics committee, Babol University of Medical Sciences.

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Bijani, A., Cumming, R.G., Hosseini, SR. et al. Obesity paradox on the survival of elderly patients with diabetes: an AHAP-based study. J Diabetes Metab Disord 17, 45–51 (2018). https://doi.org/10.1007/s40200-018-0337-7

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  • DOI: https://doi.org/10.1007/s40200-018-0337-7

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