title: BMI and coronary heart disease risk among low-income and underinsured diabetic patients.
abstract: OBJECTIVE
  The association between obesity and coronary heart disease (CHD) risk remains debatable, and no studies have assessed this association among diabetic patients. The aim of our study was to investigate the association between BMI and CHD risk among patients with type 2 diabetes.
  
  
  METHODS
  The sample included 30,434 diabetic patients (10,955 men and 19,479 women) 30-95 years of age without a history of CHD or stroke in the Louisiana State University Hospital-Based Longitudinal Study.
  
  
  RESULTS
  During a mean follow-up period of 7.3 years, 7,414 subjects developed CHD. The multivariable-adjusted hazard ratios for CHD across levels of BMI at baseline (18.5-24.9, 25-29.9, 30-34.9, 35-39.9, and ≥40 kg/m(2)) were 1.00, 1.14 (95% CI 1.00-1.29), 1.27 (1.12-1.45), 1.54 (1.34-1.78), and 1.42 (1.23-1.64) (Ptrend < 0.001) in men and 1.00, 0.95 (0.85-1.07), 0.95 (0.84-1.06), 1.06 (0.94-1.20), and 1.09 (1.00-1.22) (Ptrend < 0.001) in women, respectively. When we used an updated mean or last visit value of BMI, the positive association between BMI and CHD risk did not change in men. However, the positive association of BMI with CHD changed to a U-shaped association in women when we used the last visit value of BMI.
  
  
  CONCLUSIONS
  Our study suggests that there is a positive association between BMI at baseline and during follow-up with the risk of CHD among patients with type 2 diabetes. We indicate a U-shaped association between BMI at the last visit and the risk of CHD among women with type 2 diabetes.
authors.affiliation: Pennington Biomedical Research Center, Baton Rouge, LA Tianjin Women's and Children's Health Center, Tianjin, China.
authors.forename: Nan
authors.initials: N
authors.lastname: Li
authors.affiliation: Pennington Biomedical Research Center, Baton Rouge, LA.
authors.forename: Peter T
authors.initials: PT
authors.lastname: Katzmarzyk
authors.affiliation: Pennington Biomedical Research Center, Baton Rouge, LA.
authors.forename: Ronald
authors.initials: R
authors.lastname: Horswell
authors.affiliation: Pennington Biomedical Research Center, Baton Rouge, LA.
authors.forename: Yonggang
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Pennington Biomedical Research Center, Baton Rouge, LA Tianjin Women's and Children's Health Center, Tianjin, China.
authors.forename: Weiqin
authors.initials: W
authors.lastname: Li
authors.affiliation: Pennington Biomedical Research Center, Baton Rouge, LA.
authors.forename: Wenhui
authors.initials: W
authors.lastname: Zhao
authors.affiliation: Pennington Biomedical Research Center, Baton Rouge, LA.
authors.forename: Yujie
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Louisiana State University Health, Baton Rouge, LA.
authors.forename: Jolene
authors.initials: J
authors.lastname: Johnson
authors.affiliation: Pennington Biomedical Research Center, Baton Rouge, LA gang.hu@pbrc.edu.
authors.forename: Gang
authors.initials: G
authors.lastname: Hu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003327:Coronary Disease / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000191:economics / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008145:Louisiana / Q000453:epidemiology; D008297:Male; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D011203:Poverty / Q000706:statistics & numerical data*; D012307:Risk Factors