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Lower BMI and T2DM risk

Lower BMI consistently associated with reduced T2DM risk

Individuals still have substantial ability to reduce diabetes risk through weight loss, regardless of genetics or family history

Lower BMI is consistently associated with reduced type II diabetes risk, among people with varied family history, genetic risk factors and weight, according to a study led by Dr Manuel Rivas of Stanford University, and colleagues. The outcomes suggest all individuals can substantially reduce their diabetes risk through weight loss and supports the broad deployment of weight loss interventions to individuals at all levels of diabetes risk.

Although weight loss interventions have shown demonstrable benefit for high-risk and prediabetic individuals, the study, ‘Homogeneity in the association of body mass index with type 2 diabetes across the UK Biobank: A Mendelian randomization study’, published in PLoS Med, sought to determine whether same benefits apply to those at lower risk.

The researchers performed a multi-stratum Mendelian randomisation study of the effect size of BMI on diabetes odds in 287,394 unrelated individuals of self-reported white British ancestry in the UK Biobank, who were recruited from across the United Kingdom from 2006 to 2010 when they were between the ages of 40 and 69 years. Individuals were stratified on the following diabetes risk factors: BMI, diabetes family history, and genome-wide diabetes polygenic risk score.

The main outcome measure was the odds ratio of diabetes per 1 BMI reduction, in the full cohort and in each stratum. They found that nearly 5% of the participants had a diagnosis of type II diabetes and diabetes prevalence was confirmed to be associated with higher BMI, a family history of type II disease and genetic risk factors. Moreover, a 1 kg/m2 BMI reduction was associated with a 1.37 fold reduction (95% CI 1.12-1.68) in type II diabetes among non-overweight individuals with BMI<25 and no family history of diabetes, similar to the effect of BMI reduction in obese individuals with a family history (1.21, 95% CI 1.13-1.29)

Although the new analysis "can determine that lower lifetime BMI is protective against diabetes, that does not necessarily imply weight loss later in life, after carrying excess weight for decades, would have the same result," they researchers cautioned.

“In conclusion, by analysing a cohort of over 280,000 individuals, we found that across BMI, family history, and genetic risk categories, genetically predicted lower BMI is consistently associated with reduced diabetes risk,” the authors concluded. “This suggests that individuals still have substantial ability to reduce diabetes risk through weight loss, regardless of genetics or family history.”

To access this paper, please click here

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