SEOUL NATIONAL UNIVERSITY HOSPITAL

- Seoul National University Hospital’s joint research team announced the results of analysis of a cohort of 1.5 million diabetic patients

- Increased risk of cardiovascular disease and death if you gain or lose more than 5% of your weight in 2 years

[Figure] U-shaped associations between body weight change and major cardiovascular events were consistently observed in diabetic patients. (From the publication)

Our clinic that recommended weight loss for diabetic patients has now discovered new findings. A study found that diabetes patients who gain or lose more than 5% in body weight are more likely to develop cardiovascular disease.

On the 7th of April, the team of Professor Kim Hyung-Kwan (Dr Park Chan Soon) of Seoul National University Hospital and Professor Han Kyung-Do of Soongsil University presented the results of a cohort analysis: a study on the relationship between weight change and cardiovascular disease in 1,522,241 diabetic patients who underwent 2 comprehensive health check-ups between 2009 and 2012.

According to recent data from the Korean Diabetes Association, the prevalence of diabetes in Korea is 13.8%. About 1 in 7 adults over the age of 30 are diabetic. Compared to the general population, diabetics are more prone to cardiovascular diseases such as myocardial infarctions and strokes and have a higher mortality rate.

In particular, being obese can increase blood cholesterol levels, blood sugar levels, and blood pressure, which are major risk factors for cardiovascular disease. Therefore, under the existing medical guidelines, weight loss was recommended for obese diabetic patients.  

However, it has not yet been proven what extent of weight loss is appropriate or whether weight loss really helps prevent cardiovascular disease. Therefore, it was necessary to study the effects of weight gain and loss on the prognosis of diabetes in patients.

The research team measured the weight change of 1,522,241 diabetic patients using data from the National Health Insurance Corporation. Patients were divided into ▲10% or more weight loss ▲5%~10% weight loss ▲stable weight (less than 5% gain or loss) ▲5%~10% weight gain ▲10% or more weight gain. Occurrences of myocardial infarction, stroke, atrial fibrillation, heart failure, and death was followed for about 7 years.

[Figure] Diabetes Mellitus patients showed U-shaped associations between body weight changes and major cardiovascular events (myocardial infarction, ischemic stroke, atrial fibrillation, and heart failure) as well as a death rate. 

The results showed that, compared to the stable weight group, the 5% or more weight loss group had a higher annual cardiovascular disease incidence and mortality rate.

In addition, compared to the 5% to 10% weight gain group, the annual cardiovascular disease incidence and mortality rate increased significantly in the 10% or more weight gain group.

In other words, there was U-shaped correlation meaning that the greater the patient's weight gain or loss, the higher the risk of cardiovascular disease and death.

Furthermore, this correlation was consistently found in underweight, normal weight, overweight, and obese diabetic patients groups regardless of their degree of obesity.

In other words, it was confirmed that the degree of weight change was more significantly involved in the occurrence of cardiovascular disease in diabetic patients than the degree of obesity.

Professor Kim Hyung-Kwan of the Department of Cardiovascular Medicine at SNUH said, “This study is significant in that it revealed that both rapid weight gain and loss in diabetic patients increase the risk of cardiovascular disease, contrary to existing guidelines.”  

He added that “We should not always think positively about weight loss in obese diabetic patients,”, and continued that “If a patient loses weight, it is necessary to comprehensively review how blood sugar level, diet, and exercise are being controlled and whether other diseases have occurred.”.

This study was published online on the 9th of last month in 'Diabetes Care (Impact Factor 19.112)', the most prestigious medical journal in the field of endocrine metabolism.

[Pictures from left] SNUH Prof Kim Hyung-Kwan, Dr Park Chan Soon and Prof Han Kyung-Do from Soongsil Univ.