title: Body mass index and mortality in patients with type 2 diabetes mellitus: A prospective cohort study of 11,449 participants.
abstract: OBJECTIVE
  To investigate the association between body-mass index and mortality in Chinese adults T2DM.
  
  
  METHODS
  11,449 participants of Kailuan Study with T2DM were included in this prospective cohort study. All-cause mortality was calculated using Kaplan-Meier analysis. Cox proportional hazards analysis was used to estimate the association between BMI and mortality.
  
  
  RESULTS
  During a mean follow-up period of 7.25±1.42years, 1254 deaths occurred. The number of deaths of the underweight, normal weight, overweight, and obese group was 23, 389, 557, and 285; the corresponding mortality was 25.0%, 13.4%, 10.3%, and 9.4%, respectively. The obese group had the lowest all-cause mortality rate (log-rank chi-square=48.430, P<0.001). After adjusting for age, sex, fasting blood glucose, smoking status, systolic blood pressure, history of hypertension, stroke, cancer and myocardial infarction, compared with the normal weight group, Multivariate Cox proportional hazard regression analysis showed that HR (95% CI) of all-cause mortality in the underweight, overweight, and obese group was 1.497 (0.962, 2.330), 0.833 (0.728, 0.952), and 0.809 (0.690, 0.949). After stratifying for age tertiles, this trend remained.
  
  
  CONCLUSIONS
  In T2DM patients in north China, the risk for all-cause mortality was lower in the overweight and the obese groups than those in the normal weight and the underweight groups.
authors.affiliation: Department of Cardiology, Tianjin Chest Hospital, Graduate School of Tianjin Medical University, Tianjin 300051, China; Department of Infectious Disease, Kailuan Hospital, Tangshan 063000, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Cardiology, Kailuan Hospital, Tangshan 063000, China. Electronic address: drwusl@163.com.
authors.forename: Shouling
authors.initials: S
authors.lastname: Wu
authors.affiliation: School of Public Heath, North China University of Science and Technology, Tangshan 063000, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Cardiology, Tianjin Chest Hospital, Graduate School of Tianjin Medical University, Tianjin 300051, China; Department of Emergency, The Affiliated Hospital of North China University of Science and Technology, Tangshan 063000, China.
authors.forename: Lixia
authors.initials: L
authors.lastname: Sun
authors.affiliation: Department of Cardiology, Tianjin Chest Hospital, Graduate School of Tianjin Medical University, Tianjin 300051, China; Department of Cardiology, Kailuan Hospital, Tangshan 063000, China.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Huang
authors.affiliation: Department of Cardiology, Kailuan Hospital, Tangshan 063000, China.
authors.forename: Liming
authors.initials: L
authors.lastname: Lin
authors.affiliation: Department of Cardiology, Kailuan Hospital, Tangshan 063000, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Cardiology, Kailuan Hospital, Tangshan 063000, China.
authors.forename: Chunpeng
authors.initials: C
authors.lastname: Ji
authors.affiliation: Department of Cardiology, Kailuan Hospital, Tangshan 063000, China; Graduate School, North China University of Science and Technology 063000, Tangshan, China.
authors.forename: Hualing
authors.initials: H
authors.lastname: Zhao
authors.affiliation: Department of Cardiology, Kailuan Hospital, Tangshan 063000, China; Graduate School, North China University of Science and Technology 063000, Tangshan, China.
authors.forename: Chunhui
authors.initials: C
authors.lastname: Li
authors.affiliation: Department of Cardiology, Kailuan Hospital, Tangshan 063000, China; Graduate School, North China University of Science and Technology 063000, Tangshan, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Song
authors.affiliation: Department of Cardiology, Tianjin Chest Hospital, Graduate School of Tianjin Medical University, Tianjin 300051, China. Electronic address: hongliangcong@126.com.
authors.forename: Hongliang
authors.initials: H
authors.lastname: Cong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000208:ethnology / Q000401:mortality; D003925:Diabetic Angiopathies / Q000150:complications / Q000453:epidemiology / Q000208:ethnology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009749:Nutrition Surveys; D009765:Obesity / Q000150:complications* / Q000208:ethnology / Q000401:mortality; D050177:Overweight / Q000150:complications* / Q000208:ethnology / Q000401:mortality; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D013851:Thinness / Q000150:complications* / Q000208:ethnology / Q000401:mortality; D055815:Young Adult
keywords: All-cause mortality; Body mass index; Chinese population; Obesity; Type 2 diabetes mellitus