| Objective:In the past,overweight or obese diabetic patients were recommended to lose weight,and recent studies have found that overweight or obese diabetic patients have better survival benefits.However,the relationship between body mass index(BMI)and mortality in patients with diabetes remain controversial,so we conduct a meta-analysis of related studies.Methods : Searched the EMbase,The Cochrane Library,Pub Med,CNKI,Wan Fang Data,and VIP database to search for the cohort study on the relationship between BMI and all-cause and cardiovascular death risk of diabetic patients before December 31,2019,filtered the literature by inclusion and exclusion criteria,and then extracted relevant data and information.Finally,Stata12.0 software was used for Meta analysis.Results:A total of 27 studies were included,including 30 cohorts with 435,599 diabetic patients.Compared with normal-weight diabetics,the risk of all-cause death in low-weight diabetics was increased by 61% [HR = 1.61,95% CI:(1.46,1.78),P = 0.000];in contrast,overweight and mild obesity was reduced by 15%and 12% respectively [HR = 0.85,95% CI:(0.81,0.90),P = 0.000 and HR =0.88,95% CI:(0.81,0.96),P = 0.004];The risk of all-cause death in diabetics with moderate obesity was decreasing,but the difference was not statistically significant [HR = 0.87,95% CI:(0.80,0.95),P = 0.557].Similarly,the risk of cardiovascular death in low-weight diabetics was increased by 62% compared with normal-weight diabetics [HR = 1.62,95% CI:(1.15,2.28),P = 0.000];However,there is no significant association between overweight or obesity and the risk of cardiovascular death in diabetics [HR = 0.96,95% CI:(0.88,1.05),P= 0.387 and HR = 1.05,95% CI:(0.83,1.35),P = 0.668 ].Conclusion:There is an overall U-shaped association between BMI and the risk of all-cause death in diabetics.Compared with normal-weight diabetics,low body weight diabetics have higher all-cause and cardiovascular mortality. |
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