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- Title
Effects of Weight Loss and Interaction with Physical Activity on Risks of Cardiovascular Outcomes in Individuals with Type 2 Diabetes.
- Authors
Cardoso, Claudia R. L.; Leite, Nathalie C.; Salles, Gil F.
- Abstract
Background: This study investigated the effects of weight loss during follow-up on cardiovascular outcomes in a type 2 diabetes cohort and tested interactions with clinical and laboratory variables, particularly physical activity, that could impact the associations. Methods: Relative weight changes were assessed in 651 individuals with type 2 diabetes and categorized as =5% loss, <5% loss, or gain. Associations between weight loss categories and incident cardiovascular outcomes (total cardiovascular events [CVEs], major adverse cardiovascular events [MACEs], and cardiovascular mortality) were assessed using multivariable Cox regression with interaction analyses. Results: During the initial 2 years, 125 individuals (19.2%) lost =5% of their weight, 180 (27.6%) lost <5%, and 346 (53.1%) gained weight. Over a median additional follow-up of 9.3 years, 188 patients had CVEs (150 MACEs) and 106 patients died from cardiovascular causes. Patients with =5% weight loss had a significantly lower risk of total CVEs (hazard ratio [HR], 0.52; 95% confidence interval, 0.33 to 0.89; P=0.011) than those who gained weight, but non-significant lower risks of MACEs or cardiovascular deaths. Patients with <5% weight loss had risks similar to those with weight gain. There were interactions between weight loss and physical activity. In active individuals, =5% weight loss was associated with significantly lower risks for total CVEs (HR, 0.20; P=0.004) and MACEs (HR, 0.21; P=0.010), whereas in sedentary individuals, no cardiovascular protective effect of weight loss was evidenced. Conclusion: Weight loss =5% may be beneficial for cardiovascular disease prevention, particularly when achieved with regular physical activity, even in high-risk individuals with long-standing type 2 diabetes.
- Subjects
WEIGHT loss; TYPE 2 diabetes; PHYSICAL activity; MAJOR adverse cardiovascular events; CARDIOVASCULAR diseases risk factors
- Publication
Endocrinology & Metabolism, 2023, Vol 38, Issue 3, p305
- ISSN
2093-596X
- Publication type
Article
- DOI
10.3803/EnM.2023.1690