The association between glycaemic control, normal weight and long‐term macrovascular outcomes in people with type 2 diabetes in China: A retrospective study

Abstract Aims To investigate associations between glycaemic control and normal body mass index (BMI) and the long‐term risk of 3‐point major adverse cardiovascular events (3P‐MACE) in patients with type 2 diabetes (T2D). Materials and Methods Adults with T2D and ≥1 glycated haemoglobin (HbA1c) and BMI record between 1 January 2007 and 31 October 2016 were included from the regional health information system of Yinzhou district, Ningbo, China. The index population comprised patients with HbA1c records ≥3 months after the initial T2D diagnosis and BMI records after the initial T2D diagnosis. Of these, patients with ≥1 BMI record after the index date were included in the sustained population. Analyses were conducted using Cox proportional hazards models. Results The index population included 5757 patients (median follow‐up 6.8 years; 1188 [20.6%] experienced 3P‐MACE). In this population, the 3P‐MACE risk was significantly reduced in patients with glycaemic control and normal BMI (18.5–23.9 kg/m 2 ) versus neither glycaemic control nor normal BMI using HbA1c cutoffs of <7.0% (adjusted hazard ratio [aHR] 0.73; 95% CI 0.62–0.86; p < 0.001) and ≤6.5% (aHR 0.76; 95% CI 0.64–0.90; p = 0.001). In the sustained population ( n = 5513), the risk of 3P‐MACE was significantly reduced in patients with sustained glycaemic control and normal BMI versus neither sustained glycaemic control nor normal BMI using HbA1c cutoffs of <7.0% (aHR 0.67; 95% CI 0.49–0.91; p = 0.012) and ≤6.5% (aHR 0.69; 95% CI 0.50–0.94; p = 0.020). Conclusions Index and sustained glycaemic control and normal BMI were associated with significant risk reduction in 3P‐MACE among Chinese patients with T2D.