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Jerant A, Bertakis KD, Franks P. Body mass index and health status in diabetic and non-diabetic individuals. Nutr Diabetes. 2015;5:e152doi: 10.1038/nutd.2015.2.
Jerant, A., Bertakis, K. D., & Franks, P. (2015). Body mass index and health status in diabetic and non-diabetic individuals. Nutrition & diabetes, 5e152. https://doi.org/10.1038/nutd.2015.2
Jerant, A, et al. "Body mass index and health status in diabetic and non-diabetic individuals." Nutrition & diabetes vol. 5 (2015): e152. doi: https://doi.org/10.1038/nutd.2015.2
Jerant A, Bertakis KD, Franks P. Body mass index and health status in diabetic and non-diabetic individuals. Nutr Diabetes. 2015 Apr 27;5:e152. doi: 10.1038/nutd.2015.2. PMID: 25915741; PMCID: PMC4423198.
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Nutr Diabetes. 2015 Apr 27;5:e152. doi: 10.1038/nutd.2015.2.

Body mass index and health status in diabetic and non-diabetic individuals.

Nutrition & diabetes

A Jerant, K D Bertakis, P Franks

Affiliations

  1. UC Davis School of Medicine, Department of Family and Community Medicine and Center for Healthcare Policy and Research, Sacramento, CA, USA.

PMID: 25915741 PMCID: PMC4423198 DOI: 10.1038/nutd.2015.2

Abstract

BACKGROUND/OBJECTIVES: There is controversy regarding the existence of a body mass index (BMI) mortality paradox in diabetes, whereby the optimal BMI category is higher than it is in non-diabetic persons. To explore possible pathways to a mortality paradox, we examined the relationship of BMI with physical and mental health status in diabetic and non-diabetic persons.

SUBJECTS/METHODS: We examined adjusted SF-12 Physical and Mental Component Summary (PCS-12 and MCS-12) scores by BMI (kg m(-2)) category (underweight, <20; normal weight, 20 to <25; overweight, 25 to <30; obese, 30 to <35; severely obese ⩾35) in adult diabetic and non-diabetic respondents to the 2000-2011 United States national Medical Expenditure Panel Surveys (N=119 161). Adjustors were age, sex, race/ethnicity, income, health insurance, education, smoking, comorbidity, urbanicity, geographic region and survey year.

RESULTS: In non-diabetic persons the adjusted mean PCS-12 score was highest (that is, most optimal) in the normal-weight category, whereas for diabetic persons the optimal adjusted mean PCS-12 score was in the overweight category (adjusted difference between non-diabetic and diabetic persons in the difference in PCS-12 means for overweight versus normal-weight category=0.8 points, 95% confidence interval; CI 0.1, 1.6; P=0.03). This paradoxical pattern was not evident for the MCS-12, and the adjusted difference between non-diabetic and diabetic persons in the difference in MCS-12 means for overweight versus obese persons was not significant (-0.3 points, 95% CI -0.9, 0.4; P=0.43). The findings were not significantly moderated by smoking status, cancer diagnosis or time period.

CONCLUSIONS: The optimal BMI category for physical health status (but not mental health status) was higher among diabetic than non-diabetic persons. The findings are consistent with a BMI physical health status paradox in diabetes and, in turn, a mortality paradox.

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