Seoul National University Hospital Weight change Severe diabetic patients are at high risk of cardiovascular disease

Kim Hyung-kwan, Seoul National University Hospital Cardiovascular Internal Medicine Professor (from left), Park Chan-soon, former physician, Han Kyung-do, Soongsil University professor[사진=서울대병원]

Diabetes patients who gain or lose more than 5% of their body weight are more likely to develop cardiovascular disease, a study has found.

Seoul National University Hospital Professor Kim Hyung-gwan’s team (Park Chan-soon’s former doctor) and Soongsil University’s Professor Han Gyeong-do’s team investigated the relationship between weight change and cardiovascular disease in 1,52,241 diabetic patients who underwent comprehensive health checkups twice between 2009 and 2012. The results of the cohort analysis were announced on the 7th.

According to the latest 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, they are more prone to cardiovascular diseases such as myocardial infarction and stroke, and have a higher mortality rate.

In particular, obesity 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 been proven to what extent weight loss is appropriate or whether weight loss actually helps prevent cardiovascular disease. Therefore, it was necessary to study the effect 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, and measured the weight change of patients with △10% or more weight △5% to 10% weight loss △Stable weight (less than 5% increase or decrease) △5% to 10% % weight gain △10% or more weight gain was classified as a group. After regarding 7 years, the occurrence of myocardial infarction, stroke, atrial fibrillation, heart failure and death was followed up.

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As a result, 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 a U-shaped correlation that the risk of cardiovascular disease and death increased as the patient’s weight increased or decreased.

This correlation was consistently shown in underweight, normal weight, overweight, and obese patients regardless of the degree of obesity in diabetic patients. 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.

Kim Hyung-kwan, a professor of Cardiovascular Medicine at Seoul National University Hospital, said, “This study is significant in that it reveals that both rapid weight gain and loss in diabetic patients increase the risk of cardiovascular disease, contrary to existing guidelines.”

He continued, “We should not think positively regarding weight loss in obese diabetic patients. If a patient loses weight, we need to comprehensively review how to control blood sugar levels, diet, and exercise, and whether other diseases have occurred. There is a need,” he added.

Meanwhile, this study was published online on the 9th of last month in ‘Diabetes Care (IF 19.112)’, a prestigious medical journal in the field of endocrine metabolism.