Response: Characterization of Patients with Type 2 Diabetes according to Body Mass Index: Korea National Health and Nutrition Examination Survey from 2007 to 2011 (Endocrinol Metab 2015;30:514-21, Dong-Hwa Lee et al.)

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Endocrinol Metab. 2016;31(2):347-348
Publication date (electronic) : 2016 June 21
doi : https://doi.org/10.3803/EnM.2016.31.2.347
Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Corresponding author: Sung Hee Choi. Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea. Tel: +82-31-787-4052, Fax: +82-31-787-7033, drshchoi@snu.ac.kr

We would like to thank professor Cho for reading our article and for providing insightful comments on our study.

In this study, which was published in Endocrinology and Metabolism, we reported the characteristics of Korean type 2 diabetes mellitus (T2DM) patients according to body mass index (BMI) using 2007 to 2011 Korea National Health and Nutrition Examination Survey data in comparison to studies conducted in Western countries [1]. We showed that the proportion of non-obese patients was higher than it was in T2DM patients in Western countries. However, higher BMI resulted in a lower rate of diabetes awareness, treatment, and target control. In particular, the prevalence of cardiovascular disease and risk factors for cardiovascular disease was significantly increased even in the non-obese population with BMI ≥23 kg/m2. Professor Cho suggested that it is necessary to consider the prevalence of cardiovascular disease in both non-diabetic and diabetic populations because non-diabetic patients with obesity also face an increased risk of cardiovascular disease. Furthermore, it is important to consider factors such as age and sex with regard to the recognition, treatment and control rate of diabetes.

Obesity is a major risk factor of cardiovascular disease. In previous studies, obesity was a risk factor of cardiovascular disease as well as diabetes [23]. In addition, a recent study demonstrated that BMI was associated with cardiovascular disease-related mortality in Asians [4].

We did not evaluate the prevalence of cardiovascular disease in the non-diabetic population in this study. However, it is possible that the prevalence of cardiovascular disease increases according to increasing BMI in the non-diabetic population, as shown in previous studies [25]. In terms of the proportion of obese subjects in young and old age groups with diabetes, the mean age of our study population with diabetes was 62.2 years, suggesting that there was a relatively small young diabetic population; our study reflected mainly older T2DM patients. We feel that further study is needed to investigate the recognition, treatment and control rates of diabetes according to age and sex.

Thank you again for your insightful and comprehensive review of our paper.

Notes

CONFLICTS OF INTEREST: No potential conflict of interest relevant to this article was reported.

References

1. Lee DH, Jung KY, Park KS, Kim KM, Moon JH, Lim S, et al. Characterization of patients with type 2 diabetes according to body mass index: Korea National Health and Nutrition Examination Survey from 2007 to 2011. Endocrinol Metab (Seoul) 2015;30:514–521. 26354494.
2. Meigs JB, Wilson PW, Fox CS, Vasan RS, Nathan DM, Sullivan LM, et al. Body mass index, metabolic syndrome, and risk of type 2 diabetes or cardiovascular disease. J Clin Endocrinol Metab 2006;91:2906–2912. 16735483.
3. Lam BC, Koh GC, Chen C, Wong MT, Fallows SJ. Comparison of body mass index (BMI), body adiposity index (BAI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) as predictors of cardiovascular disease risk factors in an adult population in Singapore. PLoS One 2015;10:e0122985. 25880905.
4. Chen Y, Copeland WK, Vedanthan R, Grant E, Lee JE, Gu D, et al. Association between body mass index and cardiovascular disease mortality in east Asians and south Asians: pooled analysis of prospective data from the Asia Cohort Consortium. BMJ 2013;347:f5446. 24473060.
5. Bogers RP, Bemelmans WJ, Hoogenveen RT, Boshuizen HC, Woodward M, Knekt P, et al. Association of overweight with increased risk of coronary heart disease partly independent of blood pressure and cholesterol levels: a meta-analysis of 21 cohort studies including more than 300 000 persons. Arch Intern Med 2007;167:1720–1728. 17846390.

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