title: Maximum BMI and microvascular complications in a cohort of Japanese patients with type 2 diabetes: the Japan Diabetes Complications Study.
abstract: The aim of this study was to examine the associations between possible indices of obesity based on information on weight history and the incidence of microvascular complications.
  
  
  
  A cohort of individuals with type 2 diabetes from 59 institutes in Japan was followed for 8years. Patients were classified into three categories according to weight at entrance and past maximum weight: normal (BMI at baseline <25kg/m(2) and maximum BMI <25kg/m(2)), past obesity (BMI at baseline <25kg/m(2) and maximum BMI ≥25kg/m(2)), and current obesity (BMI at baseline ≥25kg/m(2)) groups. The outcomes were diabetic retinopathy and overt nephropathy.
  
  
  
  BMI at maximum and baseline of the 1809 patients was 26.5±3.5 and 23.1±3.0kg/m(2) (p<0.01), respectively (23.0±1.6 and 20.6±1.9kg/m(2) for normal, 27.4±2.0 and 22.8±1.4kg/m(2) for past obesity, and 30.1±2.9 and 27.0±1.8kg/m(2) for current obesity). The hazard ratios of past and current obesity compared to normal were 1.92 (95% CI, 1.08-3.41; p=0.03) and 2.21 (1.16-4.22; p=0.02), respectively, for overt nephropathy and 1.38 (1.05-1.83; p=0.02) and 1.64 (1.18-2.28; p<0.01), respectively, for diabetic retinopathy after adjustment for confounders.
  
  
  
  Past obesity as well as current obesity were associated with increased risks of microvascular complications. Further identification of high-risk populations may be possible by classifying normal weight patients by past obesity.
authors.affiliation: Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Tanaka
authors.affiliation: Division of Medical Statistics, Shiga University of Medical Science, Tsukinowa Seta-cho, Ohtsu, Shiga, Japan.
authors.forename: Sachiko
authors.initials: S
authors.lastname: Tanaka
authors.affiliation: Teikyo Academic Research Center, Teikyo University, Kaga, Itabashi-ku, Tokyo, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Iimuro
authors.affiliation: Division of Endocrinology and Metabolism, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi, Japan.
authors.forename: Shun
authors.initials: S
authors.lastname: Ishibashi
authors.affiliation: Department of Ophthalmology, Yamagata University Faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata, Japan.
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Yamashita
authors.affiliation: Health Care Center, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara-shi, Kanagawa, Japan.
authors.forename: Tatsumi
authors.initials: T
authors.lastname: Moriya
authors.affiliation: Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, 38 Morohongo, Moroyama, Iruma-gun, Saitama, Japan.
authors.forename: Shigehiro
authors.initials: S
authors.lastname: Katayama
authors.affiliation: The Institute for Adult Diseases Asahi Life Foundation, 1-6-1 Marunouchi Chiyoda-ku, Tokyo, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Akanuma
authors.affiliation: Department of Integrated Science and Engineering for Sustainable Society, Chuo University, 1-13-27, Kasuga, Bunkyo-ku, Tokyo, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ohashi
authors.affiliation: Department of Internal Medicine, University of Tsukuba Institute of Clinical Medicine, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Yamada
authors.affiliation: Tokyo Metropolitan Geriatric Hospital, 35-2, Sakae-cho Itabashi-ku, Tokyo, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Araki
authors.affiliation: Tokyo Metropolitan Geriatric Hospital, 35-2, Sakae-cho Itabashi-ku, Tokyo, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Ito
authors.affiliation: Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine, 1-757 Asahi-machi, Chuo-ku, Niigata, Japan. Electronic address: sone@med.niigata-u.ac.jp.
authors.forename: Hirohito
authors.initials: H
authors.lastname: Sone
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D015331:Cohort Studies; D015897:Comorbidity; D015986:Confounding Factors, Epidemiologic; D048909:Diabetes Complications / Q000453:epidemiology* / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000453:epidemiology*; D003928:Diabetic Nephropathies / Q000453:epidemiology*; D003930:Diabetic Retinopathy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology* / Q000628:therapy; D016491:Peripheral Vascular Diseases / Q000453:epidemiology*; D011446:Prospective Studies; D012306:Risk
keywords: Body weight; Diabetic retinopathy; Obesity; Overt nephropathy; Trajectory