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Obesity and life expectancy with and without diabetes in adults aged 55 years and older in the Netherlands: a prospective cohort study

Dhana, Klodian, Nano, Jana, Ligthart, Symen, Peeters, Anna, Hofman, Albert, Nusselder, Wilma, Dehghan, Abbas and Franco, Oscar H. 2016, Obesity and life expectancy with and without diabetes in adults aged 55 years and older in the Netherlands: a prospective cohort study, PLoS medicine, vol. 13, no. 7, pp. 1-13, doi: 10.1371/journal.pmed.1002086.

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Title Obesity and life expectancy with and without diabetes in adults aged 55 years and older in the Netherlands: a prospective cohort study
Author(s) Dhana, Klodian
Nano, Jana
Ligthart, Symen
Peeters, Anna
Hofman, Albert
Nusselder, Wilma
Dehghan, Abbas
Franco, Oscar H.
Journal name PLoS medicine
Volume number 13
Issue number 7
Start page 1
End page 13
Total pages 13
Publisher Public Library of Science
Place of publication San Francisco, Calif.
Publication date 2016-07-19
ISSN 1549-1676
Keyword(s) Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
BODY-MASS INDEX
CARDIOVASCULAR-DISEASE
PHYSICAL-ACTIVITY
TABLE ANALYSIS
US ADULTS
RISK
ROTTERDAM
MORTALITY
TRENDS
LOST
Summary BACKGROUND: Overweight and obesity are associated with increased risk of type 2 diabetes. Limited evidence exists regarding the effect of excess weight on years lived with and without diabetes. We aimed to determine the association of overweight and obesity with the number of years lived with and without diabetes in a middle-aged and elderly population.
METHODS AND FINDINGS: The study included 6,499 individuals (3,656 women) aged 55 y and older from the population-based Rotterdam Study. We developed a multistate life table to calculate life expectancy for individuals who were normal weight, overweight, and obese and the difference in years lived with and without diabetes. For life table calculations, we used prevalence, incidence rate, and hazard ratios (HRs) for three transitions (healthy to diabetes, healthy to death, and diabetes to death), stratifying by body mass index (BMI) at baseline and adjusting for confounders. During a median follow-up of 11.1 y, we observed 697 incident diabetes events and 2,192 overall deaths. Obesity was associated with an increased risk of developing diabetes (HR: 2.13 [p < 0.001] for men and 3.54 [p < 0.001] for women). Overweight and obesity were not associated with mortality in men and women with or without diabetes. Total life expectancy remained unaffected by overweight and obesity. Nevertheless, men with obesity aged 55 y and older lived 2.8 (95% CI -6.1 to -0.1) fewer y without diabetes than normal weight individuals, whereas, for women, the difference between obese and normal weight counterparts was 4.7 (95% CI -9.0 to -0.6) y. Men and women with obesity lived 2.8 (95% CI 0.6 to 6.2) and 5.3 (95% CI 1.6 to 9.3) y longer with diabetes, respectively, compared to their normal weight counterparts. Since the implications of these findings could be limited to middle-aged and older white European populations, our results need confirmation in other populations.
CONCLUSIONS: Obesity in the middle aged and elderly is associated with a reduction in the number of years lived free of diabetes and an increase in the number of years lived with diabetes. Those extra years lived with morbidity might place a high toll on individuals and health care systems.
Language eng
DOI 10.1371/journal.pmed.1002086
Field of Research 111799 Public Health and Health Services not elsewhere classified
Socio Economic Objective 920104 Diabetes
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, Dhana et al.
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30085195

Document type: Journal Article
Collections: School of Health and Social Development
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.