147-OR: Association of Body Mass Index and Time in Target Range with All-Cause and Cardiovascular Mortality in Adults with Type 2 Diabetes

Introduction and Objective: We aimed to characterize the long-term changes using body mass index (BMI) time in target range (TTR) and test its independent association with all-cause and cardiovascular mortality. Methods: This study included 3524 patients (58% men) aged 40-80 years with at least 3 BMI measurements within 4 years since their first inpatient diagnosis of type 2 diabetes. TTR was defined as the percentage of time during which BMI was within 18.5-27.9 kg/m2. The associations of BMI TTR with all-cause and cardiovascular mortality were analyzed using multivariable Cox models and restricted cubic spline. Results: The mean BMI was 24.9 ± 3.8 kg/m2 and the mean BMI during the follow-up was 24.6 ± 3.3 kg/m2. During a mean follow-up of 4.9 years, 787 patients died, of whom 158 were died due to cardiovascular events. Each 1 SD (14.4%) increase in BMI TTR was significantly associated with a decreased risk of all-cause mortality (hazard ratio [HR] 0.86, 95% confidence interval [CI] 0.82-0.90) and cardiovascular mortality (HR 0.87, 95%CI 0.78-0.98) after adjusting for variability of BMI and traditional cardiovascular risk factors. Similar associations remained consistent among patients with lower baseline or mean BMI, and independent of age. Furthermore, restricted cubic spline showed a nonlinear association and indicated that patients with TTR ≥71.4% was associated with a lower risk of all-cause and cardiovascular mortality. Conclusion: Higher BMI TTR was independently associated with lower risks of all-cause and cardiovascular mortality. Thus, appropriate approaches to elevate BMI TTR may help minimize the burden of all-cause and cardiovascular mortality for middle aged and older adults with type 2 diabetes. Disclosure Y. Bao: None. T. Hu: None. Y. Xu: None. X. Li: None. X. Ma: None.