| アブストラクト | AIMS: This study aimed to evaluate the impact of intentional weight loss on the risk of microvascular and macrovascular complications in people with obesity and type 2 diabetes (T2D), while accounting for changes in glycaemic control. MATERIALS AND METHODS: Data from adults living with obesity (body mass index [BMI] >/=30 kg/m(2)) and T2D were extracted from Clinical Practice Research Datalink (CPRD) Aurum database from 2006 to 2022. Incidence of microvascular (retinopathy, neuropathy, and chronic kidney disease [CKD]) and macrovascular (myocardial infarction [MI], peripheral artery disease [PAD], and stroke) complications following a 4-year intentional weight loss period were quantified, and risk of outcomes estimated using Cox proportional hazard regression. RESULTS: Data from 100 507 people (mean age 53.3 years; 58% male) was included. Mean [SD] relative reduction in BMI was -2.2% [9.1%] and mean [SD] absolute change in HbA(1c) was 0.0% [1.9%]. Risk of composite microvascular and macrovascular complications was significantly reduced per 1% BMI reduction (hazard ratio [HR] 0.990 [95% CI 0.988, 0.992] and 0.996 [95% CI 0.994, 0.998], respectively) and per 1%-point decrease in HbA(1c) (HR 0.875 [95% CI 0.866, 0.884] and 0.872 [95% CI 0.862, 0.883]). Results were consistent across all subgroups. Reductions in BMI and HbA(1c) were associated with reduced risk of retinopathy, neuropathy, CKD, and PAD. Reductions in HbA(1c)-only were associated with reduced risk of MI and stroke. CONCLUSIONS: A reduction in BMI and HbA(1c) by intentional weight loss, independently and concomitantly, was associated with a reduced risk of microvascular and macrovascular complications in people with obesity and T2D. |
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| ジャーナル名 | Diabetes, obesity & metabolism |
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| Pubmed追加日 | 2025/12/10 |
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| 投稿者 | Jain, Akshay; Kristensen, Peter Norgaard; Wasehuus, Rie Strobeck; Kruse, Christian; Nortoft, Emil |
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| 組織名 | TLC Diabetes and Endocrinology, Surrey, British Columbia, Canada.;TLC Diabetes and Endocrinology, University of British Columbia, Vancouver,;British Columbia, Canada.;Novo Nordisk A/S, Soborg, Denmark. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/41369027/ |
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