In what scientists are calling an "obesity paradox," new research out of Denmark has found being underweight — not overweight — poses the greatest risk of death from heart disease among women who have diabetes.
In a study presented to a meeting of the European Society of Cardiology in Amsterdam this week, researchers reported very thin Type 2 diabetics are twice as likely to die from coronary artery disease than normal-weight women — a finding that suggests underweight women with CAD should actually gain weight to reduce their risk of death.
"The increasing prevalence of obesity is concerning because it is a major risk factor for cardiovascular disease, early death, and other diseases like diabetes mellitus Type 2, high blood pressure, and high cholesterol," said lead researcher Aziza Azimi, M.D. "To our knowledge until now the impact of weight change on risk of death in women with CAD has not been studied."
For the study, researchers examined the medical records of more than 1,600 women with CAD and different body weight classes. Patients were followed for 6 years, during which time investigators compared women who maintained their weight, and those who lost or gained weight. The women were also divided into four weight classes by body mass index (BMI): underweight, normal weight, overweight, and obese.
The results showed that maintaining weight lowered the risk of death in obese women with CAD, and that weight gain and weight loss did not appear to affect their risk of CAD death compared to the normal weight group. But underweight women who maintained their weight significantly increased their risk of death by twofold and those who lost weight over the course of the study increased their risks further.
"Obese women are more likely to be treated early with statins, antihypertensive or diabetes drugs, and this may reduce their risk," said Dr. Azimi. "Weight maintenance or weight loss seems to increase the risk of death in underweight women with CAD. Our findings suggest that these women should gain weight in order to reduce their risk of death."
She added: "These data appear to be against the common sense that obesity is a risk factor for cardiovascular mortality as underweight has been even more strongly related to worse clinical outcome than overweight. Future investigations will be necessary to prove this new concept."
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