Investigating the causal association of generalized and abdominal obesity with microvascular complications in patients with type 2 diabetes: A community‐based prospective study
Authors' conclusion
Generalized but not abdominal obesity was associated with an increased risk for the overall DMC, whereas both obesities were causally related to DN, albeit not DR, in T2D. Routine weight management should not be neglected in diabetes care, particularly in women.
Study context
- Population
- Patients with clinically diagnosed T2D without diabetic microvascular complications (DMC) at baseline, community-based cohort in China, enrolled 2017–2019, followed annually until 2022
- Participants
- 1,436 patients
- Exposure
- Body mass index (BMI) and waist circumference (WC) and incident DMC
- Outcome
- New-onset DMC (DN and DR)
- Follow-up
- Four visits, until 2022
Methodological detailscommunity-based, marginal structural Cox models with inverse probability weighting
- Community-based
- Marginal structural Cox models with inverse probability weighting
Main finding
As reported in the abstract
Incident DMC, DN and DR per 1 kg/m² increase in BMI and per 1 cm increase in WC
- Incident DMC cases
- 360
- Incident diabetic nephropathy (DN) cases
- 109
- Incident diabetic retinopathy (DR) cases
- 277
- Overall DMC, per 1 kg/m² BMI increase: multivariable-adjusted HR
- 1.037 (1.005-1.071) (95% CI)
- DN, per 1 kg/m² BMI increase: multivariable-adjusted HR
- 1.117 (1.062-1.175) (95% CI)
- DR, per 1 kg/m² BMI increase: multivariable-adjusted HR
- 1.018 (0.980-1.059) (95% CI)
- Overall DMC, per 1 cm WC increase: multivariable-adjusted HR
- 1.005 (0.994-1.017) (95% CI)
- DN, per 1 cm WC increase: multivariable-adjusted HR
- 1.034 (1.018-1.051) (95% CI)
- DR, per 1 cm WC increase: multivariable-adjusted HR
- 1.000 (0.987-1.014) (95% CI)
Observational data: associations, not effects.
Further findings
BMI and WC categories; subgroups by sex
- Similar patterns across BMI and WC categories; positive association appeared more pronounced in women
Original publication
Investigating the causal association of generalized and abdominal obesity with microvascular complications in patients with type 2 diabetes: A community‐based prospective study. Diabetes Obes Metab. Published 2 May 2024. doi:10.
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