The associations of body mass index and waist circumference with the risk of diabetic complications in people with type 2 diabetes mellitus

AIMS: To determine the associations of body mass index (BMI) and waist circumference (WC) with severe diabetic complications in patients with type 2 diabetes. MATERIALS AND METHODS: In total, 114 254 participants with type 2 diabetes (82% male; mean age, 52.52 ± 8.27 years; median follow-up, 4.64 years) were enrolled from a nationwide Japanese medical claims database. Cox proportional models with multivariate adjustment were used to assess the associations of BMI and WC with treatment-requiring diabetic eye disease (TRDED), initiation of dialysis, coronary artery disease (CAD), cerebrovascular disease (CVD), heart failure (HF) and amputation. RESULTS: /WC ≥ 90 cm significantly reduced the risk of dialysis (HR = 0.42, 95% CI = 0.29-0.62) and increased the risk of HF (HR = 1.33, 95% CI = 1.03-1.72). CONCLUSIONS: BMI/WC had both positive and negative associations with diabetic complications. Therefore, each patient's BMI/WC target should be carefully determined for each diabetic complication, considering the risk of developing other diseases.