Body Weight Variability and Risk of Cardiovascular Outcomes and Death in the Context of Weight Loss Intervention Among Patients With Type 2 Diabetes

Key Points Question How does an intensive lifestyle intervention affect the association between variability in adiposity indices and cardiovascular outcomes and deaths among adults with type 2 diabetes? Findings In this cohort study of 3604 adults with type 2 diabetes, a greater variability in body mass index and waist circumference was independently associated with higher risks of cardiovascular events, cardiovascular mortality, and all-cause mortality in the control group. In the intensive lifestyle intervention group, no association was observed between variability in these indices and the outcomes. Meaning These findings suggest that weight fluctuations during weight loss attempts may lead to increased cardiovascular and mortality risk among individuals with type 2 diabetes.

[1]  Kyungdo Han,et al.  Body Weight Variability and the Risk of Cardiovascular Outcomes and Mortality in Patients With Type 2 Diabetes: A Nationwide Cohort Study , 2020, Diabetes Care.

[2]  8. Obesity Management for the Treatment of Type 2 Diabetes: Standards of Medical Care in Diabetes—2020 , 2019, Diabetes Care.

[3]  Sang Min Park,et al.  Impact of Discrepancies in General and Abdominal Obesity on Major Adverse Cardiac Events , 2019, Journal of the American Heart Association.

[4]  E. R. van den Heuvel,et al.  Association of Variability in Body Mass Index and Metabolic Health With Cardiometabolic Disease Risk , 2019, Journal of the American Heart Association.

[5]  F. Hsu,et al.  Body Mass Index, Change in Weight, Body Weight Variability and Outcomes in Type 2 Diabetes Mellitus (from the ACCORD Trial). , 2019, The American journal of cardiology.

[6]  Songzhu Zhao,et al.  Visit-to-Visit Glycemic Variability and Risks of Cardiovascular Events and All-Cause Mortality: The ALLHAT Study , 2019, Diabetes Care.

[7]  D. Waters,et al.  Body Weight Variability and Cardiovascular Outcomes in Patients With Type 2 Diabetes Mellitus , 2018, Circulation. Cardiovascular quality and outcomes.

[8]  B. Pereira,et al.  Effect of High-Intensity Interval Training on Total, Abdominal and Visceral Fat Mass: A Meta-Analysis , 2018, Sports Medicine.

[9]  D. Waters,et al.  Body‐Weight Fluctuations and Outcomes in Coronary Disease , 2017, The New England journal of medicine.

[10]  K. Flegal,et al.  Trends in Obesity Among Adults in the United States, 2005 to 2014. , 2016, JAMA.

[11]  S. Heymsfield,et al.  Body composition phenotypes and obesity paradox , 2015, Current opinion in clinical nutrition and metabolic care.

[12]  L. Geiss,et al.  Prevalence of and Trends in Diabetes Among Adults in the United States, 1988-2012. , 2015, JAMA.

[13]  J. Montani,et al.  Dieting and weight cycling as risk factors for cardiometabolic diseases: who is really at risk? , 2015, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[14]  A. Kennedy,et al.  Weight Cycling Increases T-Cell Accumulation in Adipose Tissue and Impairs Systemic Glucose Tolerance , 2013, Diabetes.

[15]  G. Bray,et al.  Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes. , 2013, The New England journal of medicine.

[16]  S. Oparil,et al.  Blood Pressure Measurement Device, Number and Timing of Visits, and Intra‐Individual Visit‐to‐Visit Variability of Blood Pressure , 2012, Journal of clinical hypertension.

[17]  J. Després,et al.  Body Fat Distribution and Risk of Cardiovascular Disease: An Update , 2012, Circulation.

[18]  M. Rondanelli,et al.  Weight cycling is associated with body weight excess and abdominal fat accumulation: a cross-sectional study. , 2011, Clinical nutrition.

[19]  Michael W. Schwartz,et al.  Obesity and Type 2 Diabetes: What Can Be Unified and What Needs to Be Individualized? , 2011, Diabetes Care.

[20]  C. Schmid,et al.  A new equation to estimate glomerular filtration rate. , 2009, Annals of internal medicine.

[21]  E. Bonora,et al.  Variability of body weight, pulse pressure and glycaemia strongly predict total mortality in elderly type 2 diabetic patients. The Verona Diabetes Study , 2008, Diabetes/metabolism research and reviews.

[22]  E. Barrett,et al.  Effect of exercise training intensity on abdominal visceral fat and body composition. , 2008, Medicine and science in sports and exercise.

[23]  Matthias Egger,et al.  The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for Reporting Observational Studies , 2007, PLoS medicine.

[24]  George A. Bray,et al.  Baseline characteristics of the randomised cohort from the Look AHEAD (Action for Health in Diabetes) study , 2006, Diabetes & vascular disease research.

[25]  H. Yatsuya,et al.  Long-term body weight fluctuation is associated with metabolic syndrome independent of current body mass index among Japanese men. , 2005, Circulation journal : official journal of the Japanese Circulation Society.

[26]  Karen C Johnson,et al.  Look AHEAD (Action for Health in Diabetes): design and methods for a clinical trial of weight loss for the prevention of cardiovascular disease in type 2 diabetes. , 2003, Controlled clinical trials.

[27]  H. Yatsuya,et al.  Long-term body weight variability is associated with elevated C-reactive protein independent of current body mass index among Japanese men , 2003, International Journal of Obesity.

[28]  R. D'Agostino,et al.  Variability of body weight and health outcomes in the Framingham population. , 1991, The New England journal of medicine.

[29]  L. Lissner,et al.  Body weight variability in men: metabolic rate, health and longevity. , 1990, International journal of obesity.

[30]  J. Rodin,et al.  Weight cycling and fat distribution. , 1990, International journal of obesity.