OR51-6 The Association between Body Mass Index and the Risk of Diabetes in the United States: a Case-control Study

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: OR51-Obesity: From Genes to Populations
Tuesday, June 18, 2013: 9:15 AM-10:45 AM
Presentation Start Time: 10:30 AM
Room 303 (Moscone Center)
Michael L Ganz1, Neil Wintfeld2, Qian Li*1, Jakob Langer2 and Mette Hammer2
1United BioSource Corporation, Lexington, MA, 2Novo Nordisk, Inc., Princeton, NJ
OBJECTIVES: Obesity is a known risk factor for type 2 diabetes mellitus (T2DM). To assess the association between body mass index (BMI) and the risk of being diagnosed with T2DM in the United States, a case-control study was conducted.

METHODS: Adults (≥ 18 years old) who were diagnosed with T2DM (defined by ICD-9-CM diagnosis codes or the use of non-insulin anti-diabetic medications) between January 2004 and October 2011 ("cases") were selected from an electronic health records database provided by an integrated health system in the Middle Atlantic region. Individuals enrolled in the health system without a T2DM diagnosis during the study period ("controls") were matched to cases, in a 1:2 ratio, based on age, sex, history of cardiac conditions or hyperinflammatory state (defined by C-reactive protein and erythrocyte sedimentation rate), and prior use of psychiatric or beta blocker medications. BMI was measured one year prior to a T2DM diagnosis (for cases) or a randomly assigned date (for controls). Individuals with no BMI measure or BMI <18.5 were excluded.  The impact of increased BMI (overweight: 25 to < 30; Obese Class I: 30 to < 35; Obese Class II: 35 to < 40; Obese Class III: ≥40), relative to normal BMI (18.5 to < 25), on a T2DM diagnosis was assessed using logistic regression, adjusting for demographic characteristics, comorbidities, use of medications, and prior use of healthcare resources.

RESULTS: The study included 12,179 cases (mean age: 55, 43% male) and 25,177 controls (mean age: 56, 45% male). An increasingly positive association between BMI category and the risk of a T2DM diagnosis was identified (odds ratio [95% confidence interval]: overweight, 1.63 [1.49-1.78]; Obesity Class I, 3.19 [2.92-3.48]; Obesity Class II, 5.86 [5.32-6.46]; Obesity Class III, 11.58 [10.46-12.82]). The impact of obesity, as measured by the odds ratios, was stronger than those of the other risk factors included in the logistic regression.

CONCLUSIONS: BMI is strongly and independently associated with the risk of being diagnosed with T2DM. The incremental association of BMI category on the risk of T2DM is stronger for people with higher BMI relative to people with lower BMI.

Disclosure: MLG: , Novo Nordisk. NW: Employee, Novo Nordisk. QL: Employee, Novo Nordisk. JL: Employee, Novo Nordisk, Employee, Novo Nordisk. MH: Employee, Novo Nordisk, Employee, Novo Nordisk.

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm

Sources of Research Support: Novo Nordisk, Inc.
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