(17-03-12) BMI-Mortality Paradox and Fitness in African American and Caucasian Men With Type 2 Diabetes.

Kokkinos P, Myers J, Faselis C, Doumas M, Kheirbek R, Nylen E.
Source
Veterans Affairs Medical Center, Cardiology Department, Washington, DC.
Abstract
OBJECTIVETo assess the association between BMI, fitness, and mortality in
African American and Caucasian men with type 2 diabetes and to explore racial
differences in this association.RESEARCH DESIGN AND METHODSWe used prospective
observational data from Veterans Affairs Medical Centers in Washington, DC, and
Palo Alto, California. Our cohort (N = 4,156; mean age 60 ?? 10.3 years)
consisted of 2,013 African Americans (mean age, 59.5 ?? 9.9 years), 2,000
Caucasians (mean age, 60.8 ?? 10.5 years), and 143 of unknown race/ethnicity.
BMI, cardiac risk factors, medications, and peak exercise capacity in metabolic
equivalents (METs) were assessed during 1986 and 2010. All-cause mortality was
assessed across BMI and fitness categories.RESULTSThere were 1,074 deaths
during a median follow-up period of 7.5 years. A paradoxic BMI-mortality
association was observed, with significantly higher risk among those with a BMI
between 18.5 and 24.9 kg/m(2) (hazard ratio [HR] 1.70 [95% CI 1.36-2.1])
compared with the obese category (BMI ??35 kg/m(2)). This association was
accentuated in African Americans (HR 1.95 [95% CI 1.44-2.63]) versus Caucasians
(HR 1.53 [1.0-2.1]). The fitness-mortality risk association for the entire
cohort and within BMI categories was inverse, independent, and graded.
Mortality risks were 12% lower for each 1-MET increase in exercise capacity,
and ??35-55% lower for those with an exercise capacity >5 METs compared with the
least fit (??5 METs).CONCLUSIONSA paradoxic BMI-mortality risk association was
observed in African American and Caucasian patients with diabetes. The exercise
capacity-mortality risk association was inverse, independent, and graded in all
BMI categories but was more potent in those with a BMI ??25 kg/m(2).

Source: Diabetes Care. 2012 Mar 7. [Epub ahead of print]

News

---

In evidenza

"L'informazione presente nel sito serve a migliorare, e non a sostituire, il rapporto medico-paziente."

Per coloro che hanno problemi di salute si consiglia di consultare sempre il proprio medico curante.