Above-normal BMI carries cardiometabolic multimorbidity risk
medwireNews: A pooled analysis of large prospective studies shows that having an increased body mass index (BMI) raises people’s risk for developing multiple cardiometabolic problems, with this risk apparent even in the overweight category.
“In view of the excess risk of death attributable to cardiometabolic multimorbidity, it is important that clinicians and their patients are informed that high BMI not only increases the risk of diabetes and vascular disease separately, but also of their more severe, comorbid forms,” say Mika Kivimäki (University College London, UK) and study co-authors.
The team defined cardiometabolic multimorbidity as any two of type 2 diabetes, coronary heart disease, and stroke. During an average follow-up of 10.7 years, this occurred among 1627 of 120,813 adults, drawn from 16 prospective European and US studies, who were free of such conditions at baseline.
Relative to people with a healthy BMI, the risk for cardiometabolic multimorbidity was increased twofold in overweight people, 4.5-fold for those with class I obesity, and 14.5-fold for those with class II or III obesity, after accounting for sociodemographic and lifestyle factors. Overall, the risk rose 1.9-fold for each 5 kg/m2 increase in BMI, and occurred irrespective of gender, age, and race.
Looking at the individual endpoints revealed that the highest risk increases were for diabetes alone, at 9.4- and 18.6-fold for class I and class II/III obesity, respectively, and for diabetes followed by vascular disease, at a corresponding 8.5- and 29.8-fold.
“The contribution of high BMI to diabetes development is marked and clearly exceeds its effect on vascular disease,” write the researchers in The Lancet Public Health.
Even being overweight increased the risk for these outcomes more than threefold, and the team says that “the excess risk associated with mild obesity and severe obesity reaches levels that are seldom seen in modern epidemiology.”
The risk for vascular disease alone was also increased, but only by a maximum of 2.2-fold, and the risk for developing vascular disease followed by diabetes was elevated between 2.4-fold, for overweight people, and 12.0-fold, for those with class II/III obesity.
“Our data support recommendations that clinicians treating overweight or obese patients with vascular disease screen for the development of diabetes,” say the researchers. “Screening for vascular disease in overweight or obese patients with diabetes is also clearly important.”
medwireNews is an independent medical news service provided by Springer Healthcare. © 2017 Springer Healthcare part of the Springer Nature group