Association of BMI and waist circumference with diabetic microvascular complications: A prospective cohort study from the UK Biobank and Mendelian randomization analysis
Authors' conclusion
Prospective observational and MR analyses provided evidence that high BMI and WC may represent potential causal risk factors for diabetic microvascular complications. Weight control might modify the risks of these complications independently of glycemic control and should be considered as a therapeutic recommendation.
Study context
- Population
- UK Biobank participants with diabetesUK Biobank
- Participants
- 30,541 participants
- Exposure
- Per-SD increase in BMI and waist circumference
- Outcome
- Diabetic complications: DR, nephropathy (DN) and DPN
Methodological detailsmultivariable-adjusted Cox proportional hazard model, two-sample Mendelian randomization
- Multivariable-adjusted Cox proportional hazard model
- Two-sample Mendelian randomization
Main finding
As reported in the abstract
DR, DN and DPN risk per-SD increase (Cox, UK Biobank cohort)
- BMI: DR, HR (95% CI) per SD
- 1.09 (1.04-1.13)
- BMI: DN, HR (95% CI) per SD
- 1.37 (1.33-1.41)
- BMI: DPN, HR (95% CI) per SD
- 1.27 (1.20-1.34)
- Waist circumference (WC): DR, HR (95% CI) per SD
- 1.11 (1.07-1.16)
- WC: DN, HR (95% CI) per SD
- 1.41 (1.36-1.46)
- WC: DPN, HR (95% CI) per SD
- 1.38 (1.30-1.45)
Observational data: associations, not effects.
Further findings
Univariate Mendelian randomization (MR): DR, DN and DPN per-SD increase
- BMI: DR, OR (95% CI) per SD
- 1.33 (1.22-1.45)
- BMI: DN, OR (95% CI) per SD
- 1.74 (1.47-2.07)
- BMI: DPN, OR (95% CI) per SD
- 2.20 (1.67-2.90)
- WC: DR, OR (95% CI) per SD
- 1.43 (1.27-1.61)
- WC: DN, OR (95% CI) per SD
- 2.03 (1.62-2.55)
- WC: DPN, OR (95% CI) per SD
- 2.80 (1.99-3.92)
- Effect sizes remained significant after adjustment for glycated hemoglobin
- GWASs of BMI and WC: 461,460 and 462,166 UK Biobank participants
Original publication
Association of BMI and waist circumference with diabetic microvascular complications: A prospective cohort study from the UK Biobank and Mendelian randomization analysis. Diabetes Res Clin Pract. Published 25 October 2023. doi:10.
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