Body mass index and health status in the Bypass Angioplasty Revascularization Investigation 2 Diabetes Trial (BARI 2D) - 06/08/11
Résumé |
Background |
The longitudinal association between obesity, weight variability, and health status outcomes is important for patients with coronary disease and diabetes.
Methods |
The BARI 2D was a multicenter randomized clinical trial designed to evaluate treatment strategies for patients with both documented stable ischemic heart disease and type 2 diabetes. We examined BARI 2D participants for 4 years to study how body mass index (BMI) was associated with health status outcomes. Health status was evaluated by the Duke Activity Status Index (DASI), RAND Energy/fatigue, Health Distress, and Self-rated Health. Body mass index was measured quarterly throughout follow-up years, and health status was assessed at each annual follow-up visit. Variation in BMI measures was separated into between-person and within-person change in longitudinal analysis.
Results |
Higher mean BMI during follow-up years (the between-person BMI) was associated with poorer health status outcomes. Decreasing BMI (the within-person BMI change) was associated with better Self-rated health. The relationships between BMI variability and DASI or Energy appeared to be curvilinear and differed by baseline obesity status. Decreasing BMI was associated with better outcomes if patients were obese at baseline but was associated with poorer DASI and Energy outcomes if patients were nonobese at baseline.
Conclusions |
For patients with stable ischemic heart disease and diabetes, weight gain was associated with poorer health status outcomes, independent of obesity-related comorbidities. Weight reduction is associated with better functional capacity and perceived energy for obese patients but not for nonobese patients at baseline.
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| RCT reg no. NCT00006305. |
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| Funding: BARI 2D is funded by the National Heart, Lung and Blood Institute and the National Institute of Diabetes and Digestive and Kidney Diseases, nos. U01 HL061744, U01 HL061746, U01 HL061748, and U01 HL063804. Significant supplemental funding is provided by GlaxoSmithKline, Collegeville, PA; Bristol-Myers Squibb Medical Imaging, Inc, North Billerica, MA; Astellas Pharma US, Inc, Deerfield, IL; Merck & Co, Inc, Whitehouse Station, NJ; Abbott Laboratories, Inc, Abbott Park, IL; and Pfizer, Inc, New York, NY. Generous support is given by Abbott Laboratories Ltd, MediSense Products, Mississauga, Canada; Bayer Diagnostics, Tarrytown, NY; Becton, Dickinson and Company, Franklin Lakes, NJ; J. R. Carlson Labs, Arlington Hts, IL; Centocor, Inc, Malvern, PA; Eli Lilly and Company, Indianapolis, IN; LipoScience, Inc, Raleigh, NC; Merck Sante, Lyon, France; Novartis Pharmaceuticals Corporation, East Hanover, NJ; and Novo Nordisk, Inc, Princeton, NJ. |
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| As a National Institutes of Health (NIH)–funded trial, we are required to abide by the NIH PubMed Central Policy that we retain the right to provide a copy of the final manuscript to the NIH upon acceptance for publication by your journal, for public archiving in PubMed Central as soon as possible but no later than 12 months after publication. |
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| The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, and Blood Institute, the National Institute of Diabetes and Digestive and Kidney Diseases, or the NIH. |
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| ClinicalTrials.gov no. NCT00006305. |
Vol 162 - N° 1
P. 184 - juillet 2011 Retour au numéro
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