Letter to the Editor
Body Mass Index, Mortality, and the Obesity Paradox in Type 2 Diabetes Mellitus: The Effect of Hypertension
AbstractTo the Editor:The article by Tobias et al provided new insight into the relation between body mass index (BMI) and mortality in people with incident type 2 diabetes mellitus.1 Their study suggested that a linear relation exists between BMI and mortality in nonsmokers (increasing BMI associated with increased hazard ratio for death) and a J-shaped relation in former or current smokers. Carnethon and colleagues alluded to the ‘‘obesity paradox’’ and showed that normal BMI was associated with increased mortality as compared with people with incident diabetes mellitus in the overweight/obese category.2 The rate of total mortality was higher in normal-weight participants than in overweight/obese participants.2 These studies did not explore the incidence of new-onset hypertension in different groups, which may explain the discrepancy in mortality rates.
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