Sex-specific association of BMI change with stroke in middle-aged and older adults with type 2 diabetes

Nutr Metab Cardiovasc Dis. 2021 Oct 28;31(11):3095-3102. doi: 10.1016/j.numecd.2021.07.007. Epub 2021 Jul 24.

Abstract

Background and aims: We aimed to evaluate the association between BMI change and stroke in middle-aged and older adults with type 2 diabetes and identify sex differences.

Methods and results: The China Health and Retirement Longitudinal Study is an ongoing national population-based cohort study. Participants aged 45 or above with type 2 diabetes were enrolled and followed for stroke incidence. BMI change was defined as BMI at 2013-BMI at 2011. Of 1774 participants (mean [SD] age in 2011, 60.23 [8.88] years), 795 (44.8 %) were men. A total of 112 incident stroke cases were confirmed up to 2018. The incidence rate of stroke was similar between men and women (6.79 % vs 5.92 %, P = 0.516). BMI increase was independently associated with an increased stroke risk (adjusted odds ratio, 1.15; 95 % CI, 1.05-1.31) in men, while this positive association was not significant in women (adjusted odds ratio, 1.12; 95 % CI, 0.98-1.29). In addition, the positive dose-response relationship between BMI increase and stroke was observed only in men.

Conclusion: Among middle-aged and older adults with type 2 diabetes, there is a sex-specific association of BMI change with stroke. An increase in BMI could result in a higher risk of incident stroke in men.

Keywords: BMI change; Cohort study; Sex difference; Stroke.

Publication types

  • Comparative Study

MeSH terms

  • Age Factors
  • Aged
  • Body Mass Index*
  • China / epidemiology
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Female
  • Humans
  • Incidence
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Obesity / diagnosis
  • Obesity / epidemiology*
  • Prognosis
  • Risk Assessment
  • Risk Factors
  • Sex Factors
  • Stroke / diagnosis
  • Stroke / epidemiology*
  • Time Factors
  • Weight Gain*