Is obesity related to microvascular and macrovascular complications in diabetes? The Wisconsin Epidemiologic Study of Diabetic Retinopathy

Abstract

Background: There are few epidemiological data describing the relationship of obesity to the incidence of microvascular and macrovascular complications in patients with diabetes.

Methods: In a population-based study performed in southern Wisconsin, 1370 persons diagnosed as having diabetes when they were 30 years of age or older (mean[+/- SD] age, 66.6 +/- 11.3 years) participated in a baseline examination, 987 in a 4-year follow-up examination, and 533 in a 10-year follow-up examination. Height and weight were measured using standard protocols. Individuals were characterized as underweight, normal weight, overweight, and obese by body mass index (expressed as weight in kilograms divided by the square of the height in meters) status. Outcomes included incidence and progression of retinopathy, incidence of gross proteinuria, incidence of lower-extremity amputation, and death due to ischemic heart disease, death due to stroke, and all-cause mortality.

Results: The prevalence of being obese was 25.2%. After other risk factors were controlled for, being underweight was associated with higher incidence of diabetic retinopathy, death from stroke, and all-cause mortality. Body mass was not associated with progression of retinopathy, incidence of gross proteinuria, amputation of a lower extremity, or death due to ischemic heart disease.

Conclusions: These data suggest that obesity in persons with older-onset diabetes is not related to the long-term incidence of microvascular and macrovascular complications.