BMI, Weight Change, and Dementia Risk in Patients With New-Onset Type 2 Diabetes: A Nationwide Cohort Study.

Ga Eun Nam, Yong Gyu Park, Kyungdo Han, Mee Kyoung Kim, Eun Sil Koh, Eun Sook Kim, Min-Kyung Lee, Bongsung Kim, Oak-Kee Hong, Hyuk-Sang Kwon

REVIEW


08 October 2019


RELEVANCE 3
INNOVATIVENESS 3
APPLICABILITY 2
OVERALL 3

PAPER DETAILS


TITLE

BMI, Weight Change, and Dementia Risk in Patients With New-Onset Type 2 Diabetes: A Nationwide Cohort Study.

ABSTRACT

OBJECTIVE
This study examined the association between baseline BMI, percentage weight change, and the risk of dementia in patients newly diagnosed with type 2 diabetes.

RESEARCH DESIGN AND METHODS
Using the South Korean National Health Insurance Service-National Health Screening Cohort database, we identified 167,876 subjects aged ≥40 years diagnosed with new-onset type 2 diabetes between 2007 and 2012. Their weight changes were monitored for ∼2 years after diagnosis, with follow-up assessments occurring for an average of 3.5 years. The hazard ratios (HRs) and Bonferroni-adjusted 95% CIs of all-cause dementia, Alzheimer disease (AD), and vascular dementia were estimated using multivariable Cox proportional hazards regression models.

RESULTS
We identified 2,563 incident dementia cases during follow-up. Baseline BMI among patients with new-onset type 2 diabetes was inversely associated with the risk of all-cause dementia and AD, independent of confounding variables ( for trend <0.001). The percentage weight change during the 2 years after a diagnosis of type 2 diabetes showed significant U-shaped associations with the risk of all-cause dementia development ( < 0.001); the HRs of the disease increased significantly when weight loss or gain was >10% (1.34 [95% CI 1.11-1.63] and 1.38 [1.08-1.76], respectively). Additionally, weight loss >10% was associated with an increased risk of AD (HR 1.26 [95% CI 1.01-1.59]).

CONCLUSIONS
A lower baseline BMI was associated with increased risks of all-cause dementia and AD in patients with new-onset type 2 diabetes. Weight loss or weight gain after the diagnosis of diabetes was associated with an increased risk of all-cause dementia. Weight loss was associated with an increased risk of AD.



AUTHOR(S)

Ga Eun Nam, Yong Gyu Park, Kyungdo Han, Mee Kyoung Kim, Eun Sil Koh, Eun Sook Kim, Min-Kyung Lee, Bongsung Kim, Oak-Kee Hong, Hyuk-Sang Kwon,

JOURNAL

Diabetes care

PLACE

United States