Association between Body Mass Index and Mortality in Type 1 Diabetes Mellitus: A Systematic Review and Meta-Analysis
Han Na Jung, Sehee Kim, Chang Hee Jung, Yun Kyung Cho
Abstract
Background: The association between body mass index (BMI) and mortality in patients with type 1 diabetes mellitus (T1DM) has been poorly examined and has never been systematically reviewed. This meta-analysis investigated the all-cause mortality risk for each BMI category among patients with T1DM. Methods: ). The Newcastle-Ottawa Scale was used to assess the risk of bias. Results: Three prospective studies involving 23,407 adults were included. The underweight group was shown to have a 3.4 times greater risk of mortality than the normal-weight group (95% confidence interval [CI], 1.67 to 6.85). Meanwhile, there was no significant difference in mortality risk between the normal-weight group and the overweight group (HR, 0.90; 95% CI, 0.66 to 1.22) or the obese group (HR, 1.36; 95% CI, 0.86 to 2.15), possibly due to the heterogeneous results of these BMI categories among the included studies. Conclusion: Underweight patients with T1DM had a significantly greater risk of all-cause mortality than their normal-weight counterparts. Overweight and obese patients showed heterogeneous risks across the studies. Further prospective studies on patients with T1DM are required to establish weight management guidelines.