Abstract
Background/Objectives:There is controversy regarding the existence of a body mass index (BMI) mortality paradox in diabetes, whereby the optimal BMI category is higher than it is in non-diabetic persons. To explore possible pathways to a mortality paradox, we examined the relationship of BMI with physical and mental health status in diabetic and non-diabetic persons.Subjects/Methods:We examined adjusted SF-12 Physical and Mental Component Summary (PCS-12 and MCS-12) scores by BMI (kg m -2) category (underweight, <20; normal weight, 20 to <25; overweight, 25 to <30; obese, 30 to <35; severely obese ≥35) in adult diabetic and non-diabetic respondents to the 2000-2011 United States national Medical Expenditure Panel Surveys (N=119 161). Adjustors were age, sex, race/ethnicity, income, health insurance, education, smoking, comorbidity, urbanicity, geographic region and survey year.Results:In non-diabetic persons the adjusted mean PCS-12 score was highest (that is, most optimal) in the normal-weight category, whereas for diabetic persons the optimal adjusted mean PCS-12 score was in the overweight category (adjusted difference between non-diabetic and diabetic persons in the difference in PCS-12 means for overweight versus normal-weight category=0.8 points, 95% confidence interval; CI 0.1, 1.6; P=0.03). This paradoxical pattern was not evident for the MCS-12, and the adjusted difference between non-diabetic and diabetic persons in the difference in MCS-12 means for overweight versus obese persons was not significant (-0.3 points, 95% CI -0.9, 0.4; P=0.43). The findings were not significantly moderated by smoking status, cancer diagnosis or time period.Conclusions:The optimal BMI category for physical health status (but not mental health status) was higher among diabetic than non-diabetic persons. The findings are consistent with a BMI physical health status paradox in diabetes and, in turn, a mortality paradox.
| Original language | English (US) |
|---|---|
| Article number | e152 |
| Journal | Nutrition and Diabetes |
| Volume | 5 |
| DOIs | |
| State | Published - Apr 27 2015 |
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ASJC Scopus subject areas
- Endocrinology, Diabetes and Metabolism
- Internal Medicine
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Body mass index and health status in diabetic and non-diabetic individuals. / Jerant, Anthony F; Bertakis, Klea D; Franks, Peter.
In: Nutrition and Diabetes, Vol. 5, e152, 27.04.2015.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Body mass index and health status in diabetic and non-diabetic individuals
AU - Jerant, Anthony F
AU - Bertakis, Klea D
AU - Franks, Peter
PY - 2015/4/27
Y1 - 2015/4/27
N2 - Background/Objectives:There is controversy regarding the existence of a body mass index (BMI) mortality paradox in diabetes, whereby the optimal BMI category is higher than it is in non-diabetic persons. To explore possible pathways to a mortality paradox, we examined the relationship of BMI with physical and mental health status in diabetic and non-diabetic persons.Subjects/Methods:We examined adjusted SF-12 Physical and Mental Component Summary (PCS-12 and MCS-12) scores by BMI (kg m -2) category (underweight, <20; normal weight, 20 to <25; overweight, 25 to <30; obese, 30 to <35; severely obese ≥35) in adult diabetic and non-diabetic respondents to the 2000-2011 United States national Medical Expenditure Panel Surveys (N=119 161). Adjustors were age, sex, race/ethnicity, income, health insurance, education, smoking, comorbidity, urbanicity, geographic region and survey year.Results:In non-diabetic persons the adjusted mean PCS-12 score was highest (that is, most optimal) in the normal-weight category, whereas for diabetic persons the optimal adjusted mean PCS-12 score was in the overweight category (adjusted difference between non-diabetic and diabetic persons in the difference in PCS-12 means for overweight versus normal-weight category=0.8 points, 95% confidence interval; CI 0.1, 1.6; P=0.03). This paradoxical pattern was not evident for the MCS-12, and the adjusted difference between non-diabetic and diabetic persons in the difference in MCS-12 means for overweight versus obese persons was not significant (-0.3 points, 95% CI -0.9, 0.4; P=0.43). The findings were not significantly moderated by smoking status, cancer diagnosis or time period.Conclusions:The optimal BMI category for physical health status (but not mental health status) was higher among diabetic than non-diabetic persons. The findings are consistent with a BMI physical health status paradox in diabetes and, in turn, a mortality paradox.
AB - Background/Objectives:There is controversy regarding the existence of a body mass index (BMI) mortality paradox in diabetes, whereby the optimal BMI category is higher than it is in non-diabetic persons. To explore possible pathways to a mortality paradox, we examined the relationship of BMI with physical and mental health status in diabetic and non-diabetic persons.Subjects/Methods:We examined adjusted SF-12 Physical and Mental Component Summary (PCS-12 and MCS-12) scores by BMI (kg m -2) category (underweight, <20; normal weight, 20 to <25; overweight, 25 to <30; obese, 30 to <35; severely obese ≥35) in adult diabetic and non-diabetic respondents to the 2000-2011 United States national Medical Expenditure Panel Surveys (N=119 161). Adjustors were age, sex, race/ethnicity, income, health insurance, education, smoking, comorbidity, urbanicity, geographic region and survey year.Results:In non-diabetic persons the adjusted mean PCS-12 score was highest (that is, most optimal) in the normal-weight category, whereas for diabetic persons the optimal adjusted mean PCS-12 score was in the overweight category (adjusted difference between non-diabetic and diabetic persons in the difference in PCS-12 means for overweight versus normal-weight category=0.8 points, 95% confidence interval; CI 0.1, 1.6; P=0.03). This paradoxical pattern was not evident for the MCS-12, and the adjusted difference between non-diabetic and diabetic persons in the difference in MCS-12 means for overweight versus obese persons was not significant (-0.3 points, 95% CI -0.9, 0.4; P=0.43). The findings were not significantly moderated by smoking status, cancer diagnosis or time period.Conclusions:The optimal BMI category for physical health status (but not mental health status) was higher among diabetic than non-diabetic persons. The findings are consistent with a BMI physical health status paradox in diabetes and, in turn, a mortality paradox.
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U2 - 10.1038/nutd.2015.2
DO - 10.1038/nutd.2015.2
M3 - Article
AN - SCOPUS:84929089675
VL - 5
JO - Nutrition and Diabetes
JF - Nutrition and Diabetes
SN - 2044-4052
M1 - e152
ER -