Diabetic complications stratified by past maximum body mass index

1Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center 2Department ofInternal Medicine, Toho University Sakura Medical Center
Takashi Yamaguchi1,Atsuhito Saiki1,Noriko Ban1,Hidetoshi Kawana1,Daiji Nagayama1,Ayako Nagumo1,MasahiroOhira1,Kei Endo1,Tomokazu Oyama1,Yoh Miyashita1,Kohji Shirai2

Background: In Japan, prevalence of obesity (especially high degree obesity values 35<BMI) is relatively
low. Therefore, relationship between degree of obesity and development of diabetic complications has
not been fully understood.Objective: To investigate the impact of past maximum BMI on the subsequentdevelopment of diabetic complications.Methods: One hundred inpatients with type 2 diabetes were divided
into 3 groups according to each patient's past maximum BMI; Group A: 25<BMI<30, Group B: 30<BMI<35 andGroup C: 35<BMI. There were no significant differences in mean age, duration of diabetes and HbA1C among
all groups. And we compared the prevalence of diabetic complications as well as other obesity-related
complications among groups retrospectively.Results: Mean past maximum BMI of each group (Group A, B andC) were 28.4, 32.1 and 37.3 respectively. In group C, the difference between past maximum BMI and meancurrent BMI (30.2) was greater than in other groups. A rate of Insulin use was significantly higher inGroup C than in Group A (Odd ratio: 6.3). With increase in past maximum BMI, the prevalence of diabetic
retinopathy, nephropathy and neuropathy became higher (Odd ratio; retinopathy: 3.4, 7.6, nephropathy:3.9, 12.3 and neuropathy: 6.9, 14.8). The prevalence of diabetic macro angiopathy (includes coronary
artery disease, cerebral infarction and peripheral artery disease) also tended to be higher in GroupC than in other groups (Odd ratio: 2.1, 2.7). Arterial stiffness (evaluated by cardio-ankle vascularindex) was significantly higher in Group C than in Group A (7.7vs9.8). The prevalence of the otherobesity-related complications (sleep apnea syndrome, osteoarthritis, liver dysfunction) showed similar
results.Conclusion: Degree of obesity may associate with future development of obesity-relatedcomplications, especially with diabetic complications.

Background: The impact of a degree of obesity on the development of diabetic and other obesity-related
complications is not fully understood.Objective: To investigate the impact of a maximum BMI in the pasthistory on the development of diabetic and other obesity-related complications.Methods: One hundred
inpatients with type 2 diabetes were divided into 3 groups according to each patients maximum BMI in
the past history (max BMI); Group A: 25<BMI<30, Group B: 30<BMI<35 and Group C: 35<BMI. And we compared
the prevalence of diabetic complications as well as other obesity-related complications amonggroups.Results: Mean max BMI (Group A, B and C) were 28.4, 32.1 and 37.3 respectively. In all groups,mean present BMI (25.8, 27.4 and 30.2) were significantly lower than those of max BMI. There were no
significant differences in mean age, duration of diabetes and HbA1C among all groups. A rate of Insulin
use was significantly higher in Group C than Group A (Odd ratio: 6.3). The prevalence of diabetic
retinopathy, nephropathy and neuropathy became higher accompanied with increased max BMI (Odd ratio;retinopathy: 3.4, 7.6, nephropathy: 3.9, 12.3 and neuropathy: 6.9, 14.8). The prevalence of diabetic
macro angiopathy (includes coronary artery disease, cerebral infarction and peripheral artery disease)tended to be higher in Group C than the other groups (Odd ratio: 2.1, 2.7). Arterial stiffness (evaluatedby cardio-ankle vascular index) was significantly higher in Group C than Group A (7.7 vs 9.8). The
prevalence of the other obesity-related complications (sleep apnea syndrome, osteoarthritis, liverdysfunction) showed similar results.Conclusion: A degree of obesity in the past history might beassociatedwithcomplications.

thedevelopmentofobesity-related

complications,especiallywithdiabetic