Evidence map›Paper›PMID 24428469›Full record

ArticleThe New England journal of medicine2014

Body-mass index and mortality among adults with incident type 2 diabetes.

Deirdre K Tobias, An Pan, Chandra L Jackson, Eilis J O'Reilly, Eric L Ding, Walter C Willett, JoAnn E Manson, Frank B Hu

Erratum issued 2 registry-linked trialsAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The New England journal of medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 2 registered trials, which are not on this map. Cited by 201 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
201citing papers in PubMed, 9 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03819790 phase4completedstarted 2018, after this paper: background citation

Variability of Glucose Assessed in a Randomized Trial Comparing the Initiation of A Treatment Approach With Biosimilar Basal Insulin Analog Or a Titratable iGlarLixi combinatioN in Type 2 Diabetes Among South Asian Subjects (VARIATION 2 SA Trial)

Ran2018Enrolled119Registered outcomes30Posted comparisons0ConditionsDiabetes Mellitus, Type 2ArmsBasal insulin Basaglar/Lantus + gliclazide MR, Basal insulin glargine and lixisenatide, Metformin
PMID 18784090PMID 24898300PMID 25011946PMID 15111485PMID 27659408PMID 18650371PMID 20403888PMID 23317344PMID 24731666PMID 25409370PMID 25562265PMID 26260346other papers from this trial
Open the trial in the graph
NCT07512609 recruitingnot on this mapstarted 2020, after this paper: background citation

Environment, Inflammation and Metabolic Diseases Study

Typeobservational_patient_registrySponsorQifu LiRan2020 to 2026Enrolled8,000ConditionsEndocrine Disease, Metabolic Disorders, Hypertension, Diabetes MellitusArmsobserve
3 · Its place in the literature

Who cites it

201 citing papers in PubMed, 9 syntheses or guidelines pooled it.

  1. Pooled it
  2. The Impact of Obesity on the Clinical Course of Inflammatory Bowel Disease: A Meta-Analysis.Medical science monitor : international medical journal of experimental and clinical research · 2017
    Pooled it
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  6. Pedometer intervention and weight loss in overweight and obese adults with Type 2 diabetes: a meta-analysis.Diabetic medicine : a journal of the British Diabetic Association · 2016
    Pooled it
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141 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Deirdre K TobiasFrom the Departments of Nutrition (D.K.T., A.P., C.L.J., E.J.O., E.L.D., W.C.W., F.B.H.) and Epidemiology (W.C.W., J.E.M., F.B.H.), Harvard School of Public Health, and the Channing Division of Network Medicine (E.J.O., E.L.D., W.C.W., F.B.H.) and the Division of Preventive Medicine (J.E.M.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School - all in Boston; and Saw Swee Hock School of Public Health and Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (A.P.).
An Pan
Chandra L Jackson
Eilis J O'Reilly
Eric L Ding
Walter C Willett
JoAnn E Manson
Frank B Hu

Funding

STATISTICAL INNOVATIONS IN RISK MODELINGP01CA087969 · BRIGHAM AND WOMEN'S HOSPITAL · 2000 to 2005
$22.5M
PROSPECTIVE STUDY OF DIET AND PROSTATE CANCERP01CA055075 · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · 1991 to 2005
$22.1M
SIGNAL TRANSDUCTION IN HUMAN ABDOMINAL AND GLUTEOFEMORAL ADIPOCYTESP30DK046200 · TUFTS MEDICAL CENTER · 1992 to 2005
$5.3M
RISK FACTORS FOR CVD IN WOMENR01HL034594 · TULANE UNIVERSITY OF LOUISIANA · 1985 to 2025
$3.5M
BIOCHEMICAL AND GENETIC MARKERS OF TYPE 2 DIABETES RISKR01DK058845 · BRIGHAM AND WOMEN'S HOSPITAL · 2001 to 2005
$3.0M
TRAINING GRANT IN ACADEMIC NUTRITIONT32DK007703 · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · 1994 to 2025
$2.1M
NCI NIH HHS 1U54CA155626-01NCI NIH HHS CA55075NCI NIH HHS CA87969NCI NIH HHS P01 CA055075NCI NIH HHS P01 CA087969NCI NIH HHS P01 CA87969NCI NIH HHS U54 CA155626NCI NIH HHS UM1 CA167552NCI NIH HHS UM1 CA176726NHLBI NIH HHS HL34594NHLBI NIH HHS R01 HL034594NIDDK NIH HHS DK58845NIDDK NIH HHS P30 DK046200NIDDK NIH HHS P30 DK46200NIDDK NIH HHS R01 DK058845NIDDK NIH HHS T32 DK007703
6 · The paper itself

Abstract

backgroundThe relation between body weight and mortality among persons with type 2 diabetes remains unresolved, with some studies suggesting decreased mortality among overweight or obese persons as compared with normal-weight persons (an "obesity paradox").

methodsWe studied participants with incident diabetes from the Nurses' Health Study (8970 participants) and Health Professionals Follow-up Study (2457 participants) who were free of cardiovascular disease and cancer at the time of a diagnosis of diabetes. Body weight shortly before diagnosis and height were used to calculate the body-mass index (BMI, the weight in kilograms divided by the square of the height in meters). Multivariable Cox models were used to estimate the hazard ratios and 95% confidence intervals for mortality across BMI categories.

resultsThere were 3083 deaths during a mean period of 15.8 years of follow-up. A J-shaped association was observed across BMI categories (18.5 to 22.4, 22.5 to 24.9 [reference], 25.0 to 27.4, 27.5 to 29.9, 30.0 to 34.9, and ≥35.0) for all-cause mortality (hazard ratio, 1.29 [95% confidence interval {CI}, 1.05 to 1.59]; 1.00; 1.12 [95% CI, 0.98 to 1.29]; 1.09 [95% CI, 0.94 to 1.26]; 1.24 [95% CI, 1.08 to 1.42]; and 1.33 [95% CI, 1.14 to 1.55], respectively). This relationship was linear among participants who had never smoked (hazard ratios across BMI categories: 1.12, 1.00, 1.16, 1.21, 1.36, and 1.56, respectively) but was nonlinear among participants who had ever smoked (hazard ratios across BMI categories: 1.32, 1.00, 1.09, 1.04, 1.14, and 1.21) (P=0.04 for interaction). A direct linear trend was observed among participants younger than 65 years of age at the time of a diabetes diagnosis but not among those 65 years of age or older at the time of diagnosis (P<0.001 for interaction).

conclusionsWe observed a J-shaped association between BMI and mortality among all participants and among those who had ever smoked and a direct linear relationship among those who had never smoked. We found no evidence of lower mortality among patients with diabetes who were overweight or obese at diagnosis, as compared with their normal-weight counterparts, or of an obesity paradox. (Funded by the National Institutes of Health and the American Diabetes Association.).

Indexed as

Body Mass IndexAdultAgedAged, 80 and overAge of OnsetBody WeightCause of DeathDiabetes Mellitus, Type 2FemaleFollow-Up StudiesHumansMiddle AgedObesityProportional Hazards Models

Identifiers

PMID24428469
PMCPMC3966911

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.