title: Overweight, obesity and risk of all-cause and cardiovascular mortality in patients with type 2 diabetes mellitus: a dose-response meta-analysis of prospective cohort studies.
abstract: Overweight and obese individuals with type 2 diabetes are recommended to lose weight, but the associations between excess body weight and all-cause and cardiovascular mortality in patients with type 2 diabetes remain controversial. Therefore, we performed a dose-response meta-analysis to investigate this association. We searched PubMed and Embase through 19th October 2014 and examined the references of retrieved articles to identify relevant prospective cohort studies. A random-effect model was used to calculate the summary risk estimates. Nine studies including 13 cohorts with 161,984 participants were identified. The relative risks (RRs) of all-cause mortality in overweight and obese patients with type 2 diabetes were 0.81 (95% confidence interval (CI) 0.74-0.90) and 0.72 (95% CI 0.63-0.81) respectively, compared with the normal or non-overweight patients. Furthermore, a 5 kg/m(2) increase in body mass index was associated with a significantly reduced risk of all-cause mortality by 5% (RR 0.95, 95% CI 0.93-0.97). However, no significant association was found between obese and/or overweight and the risk of cardiovascular mortality in type 2 diabetic patients (RR 0.89; 95% CI 0.66-1.20 for overweight and RR 0.77; 95% CI 0.54-1.10 for obesity, respectively). The findings from the present meta-analysis indicate that excess body weight may be a protective factor for all-cause mortality among patients with type 2 diabetes.
authors.affiliation: The Second School of Clinical Medicine (Zhongnan Hospital), Wuhan University, Wuhan, People's Republic of China.
authors.forename: Xue-ming
authors.initials: XM
authors.lastname: Liu
authors.forename: Yu-jian
authors.initials: YJ
authors.lastname: Liu
authors.forename: Jian
authors.initials: J
authors.lastname: Zhan
authors.forename: Qi-qiang
authors.initials: QQ
authors.lastname: He
mesh_terms: D015992:Body Mass Index; D001835:Body Weight; D002318:Cardiovascular Diseases / Q000150:complications / Q000401:mortality*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000150:complications* / Q000401:mortality; D050177:Overweight / Q000150:complications* / Q000401:mortality; D011446:Prospective Studies; D012306:Risk; D040242:Risk Reduction Behavior