Effects of BMI and LDL-cholesterol change pattern on cardiovascular disease in normal adults and diabetics

Tae Mi Youk, Min Jin Kang, Sun Ok Song, Eun Cheol Park

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8 Citations (Scopus)


Introduction To examine how the risk of cardiovascular disease changes according to degree of change in body mass index (BMI) and low-density lipoprotein (LDL)-cholesterol in patients with diabetes using the health medical examination cohort database of the National Health Insurance Service in Korea. In comparison, the pattern in a non-diabetic control group was also examined. Research design and methods The study samples were 13 800 patients with type 2 diabetes and 185 898 non-diabetic controls, and their baseline characteristics and repeatedly measured BMI and LDL-cholesterol until occurrence of cardiovascular disease were collected in longitudinal data. We used the variability model that is joint of mixed effects and regression model, then estimated parameters about variability by Bayesian methods. Results The risk of cardiovascular disease was increased significantly with high average real variability (ARV) of BMI in the patients with diabetes, but the risk of cardiovascular disease was not increased according to degree of ARV in non-diabetic controls. The Bayesian variability model was used to analyze the effects of BMI and LDL-cholesterol change pattern on development of cardiovascular disease in diabetics, showing that variability did not have a statistically significant effect on cardiovascular disease. This shows the danger of the former simple method when interpreting only the mean of the absolute value of the variation. Conclusions The approach of simple SD in previous studies for estimation of individual variability does not consider the order of observation. However, the Bayesian method used in this study allows for flexible modeling by superimposing volatility assessments on multistage models.

Original languageEnglish
Article numbere001340
JournalBMJ Open Diabetes Research and Care
Issue number2
Publication statusPublished - 2020 Dec 22

Bibliographical note

Publisher Copyright:
© 2020 Author(s). Published by BMJ.

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism


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