The Evidence for an Obesity Paradox in Type 2 Diabetes Mellitus.
- Author:
Seung Jin HAN
1
;
Edward J BOYKO
Author Information
- Publication Type:Review
- Keywords: Bias; Body mass index; Diabetes mellitus, type 2; Epidemiology; Mortality; Obesity; Survival
- MeSH: Bias (Epidemiology); Body Mass Index; Chronic Disease; Diabetes Mellitus, Type 2*; Epidemiologic Studies; Epidemiology; Humans; Life Style; Mortality; Obesity*; Overweight; Risk Factors; Weight Loss
- From:Diabetes & Metabolism Journal 2018;42(3):179-187
- CountryRepublic of Korea
- Language:English
- Abstract: Although overweight/obesity is a major risk factor for the development of type 2 diabetes mellitus, there is increasing evidence that overweight or obese patients with type 2 diabetes mellitus experience lower mortality compared with patients of normal weight. This paradoxical finding, known as the “obesity paradox,” occurs in other chronic diseases, and in type 2 diabetes mellitus is particularly perplexing given that lifestyle intervention with one goal being weight reduction is an important feature of the management of this condition. We summarize in this review the findings from clinical and epidemiologic studies that have investigated the association between overweight and obesity (usually assessed using body mass index [BMI]) and mortality in type 2 diabetes mellitus and discuss potential causes of the obesity paradox. We conclude that most studies show evidence of an obesity paradox, but important conflicting findings still exist. We also evaluate if potential bias might explain the obesity paradox in diabetes, including, for example, the presence of confounding factors, measurement error due to use of BMI as an index of obesity, and reverse causation.
