Introduction and Objective: The Chinese diabetes guideline recommends a normal BMI as a component of comprehensive management of T2D. However, evidence on the independent or combined effects of glycemic control and normal BMI on long-term macrovascular outcomes is limited.Methods: Regional electronic health record data from Yinzhou Ningbo China (2006/1/1 – 2021/10/30) was used. Adult patients with T2D and no prior cardiovascular events who had ≥ 1 HbA1c record between 2007/1/1 and 2016/10/31 were included to ensure ≥ 5 years follow-up. The index date was the first HbA1c occurring ≥ 90 days after initial T2D diagnosis. Glycemic control was defined as HbA1c ≤ 6.5% or <7.0%. The BMI closest to the index date was identified with a normal range of 18.5-24 kg/m². Patients were categorized by the attainment of the two targets. For weight effect alone, BMI was categorized by Chinese cut-offs. Cox proportional hazards model was used to analyze the incidence of 3-point major adverse cardiovascular events (3P-MACE).Results: Among 5,757 patients (mean age 61.6 years; 52.5% female) observed for a median of 6.8 years, 1,188 (20.6%) experienced 3P-MACE with an incidence rate of 3.1/100 person-years. Compared to patients achieving neither strict glycemic control (HbA1c≤ 6.5%) nor normal weight, lower 3P-MACE risk was observed in patients achieving only normal weight (0.850 [hazard ratio], 0.737-0.980 [95% confidence interval]), only glycemic control (0.762, 0.644-0.901) and both targets (0.759, 0.642-0.898). A more consistent trend was observed when HbA1c target was set at < 7.0%. In the weight alone analysis, after adjusting HbA1c and other confounders, patients with underweight (1.153, 0.802-1.658), overweight (1.069, 0.943-1.211), and obesity (1.270, 1.058-1.524) had higher risks compared to those with normal weight.Conclusion: Glycemic control and normal weight were associated with a significantly lower risk of long-term macrovascular outcomes in patients with T2D.
Q. Pan: None. F. Sun: None. M. Zhang: None. S. Zhan: None. L. Guo: Research Support; Abbott, AstraZeneca, Bayer Pharmaceuticals, Inc, Eli Lilly and Company, Innovent Biologics, Merck & Co., Inc, MSD Life Science Foundation, Novo Nordisk A/S, Sanofi, Jiangsu Hengrui Pharmaceuticals Co., Ltd, Tonghua Dongbao.
Source link
Leave a Reply