{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T01:46:28Z","timestamp":1789782388608,"version":"4.0.1"},"reference-count":28,"publisher":"The Endocrine Society","issue":"5","license":[{"start":{"date-parts":[[2024,7,26]],"date-time":"2024-07-26T00:00:00Z","timestamp":1721952000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>A few studies have evaluated all-cause mortality or risk of cardiovascular diseases according to the body mass index (BMI) level in patients with type 2 diabetes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>We evaluated all-cause mortality and the incidence of cardiovascular diseases in lean patients with newly diagnosed type 2 diabetes in Korea. Additionally, we aimed to determine a difference in all-cause mortality and the incidence of cardiovascular diseases according to changes in BMI over time among patients with newly diagnosed type 2 diabetes in Korea.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We analyzed 419 509 patients with newly diagnosed type 2 diabetes who underwent health screening between 2010 and 2014 and followed up until 2019. We conducted a multivariate Cox proportional hazards model to determine the association between BMI and all-cause mortality or risk of cardiovascular diseases.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Lean patients with type 2 diabetes had a higher risk of all-cause mortality [hazard ratio (HR): 2.106, 95% confidence interval (CI): 1.974-2.248], cardiovascular disease (HR: 1.132, 95% CI: 1.078-1.189), coronary heart disease (HR: 1.219, 95% CI: 1.124-1.323), heart failure (HR: 1.405, 95% CI: 1.279-1.543), stroke (HR: 1.155, 95% CI: 1.024-1.302), and ischemic stroke (HR: 1.205, 95% CI: 1.045-1.388) compared to patients with type 2 diabetes and normal BMI. Patients with newly diagnosed type 2 diabetes had the highest all-cause mortality when they remained lean during the follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Our findings underscore the critical role of maintaining an appropriate weight status to reduce all-cause mortality and incidence of cardiovascular diseases among lean patients with newly diagnosed type 2 diabetes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgae449","type":"journal-article","created":{"date-parts":[[2024,7,26]],"date-time":"2024-07-26T09:28:56Z","timestamp":1721986136000},"page":"e1547-e1554","source":"Crossref","is-referenced-by-count":4,"title":["All-cause Mortality and Incidence of Cardiovascular Diseases in Lean Patients With Newly Diagnosed Type 2 Diabetes"],"prefix":"10.1210","volume":"110","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2101-6661","authenticated-orcid":false,"given":"Do Kyeong","family":"Song","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Ewha Womans University College of Medicine , Seoul 07804 ,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2980-6943","authenticated-orcid":false,"given":"Jongmin","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Environmental Medicine, College of Medicine, Ewha Womans University , Seoul 07804 ,","place":["Republic of Korea"]},{"name":"Institute of Ewha-SCL for Environmental Health (IESEH), College of Medicine, Ewha Womans University , Seoul 07804 ,","place":["Republic of Korea"]},{"name":"Department of Human Systems Medicine, College of Medicine, Seoul National University , Seoul 03080 ,","place":["Republic of Korea"]},{"name":"Integrated Major in Innovative Medical Science, Seoul National University Graduate School , Seoul 03080 ,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5120-7365","authenticated-orcid":false,"given":"Yeon-Ah","family":"Sung","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Ewha Womans University College of Medicine , Seoul 07804 ,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8552-9066","authenticated-orcid":false,"given":"Young Sun","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Ewha Womans University College of Medicine , Seoul 07804 ,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4446-6470","authenticated-orcid":false,"given":"Hyejin","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Ewha Womans University College of Medicine , Seoul 07804 ,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4224-3858","authenticated-orcid":false,"given":"Eunhee","family":"Ha","sequence":"additional","affiliation":[{"name":"Department of Environmental Medicine, College of Medicine, Ewha Womans University , Seoul 07804 ,","place":["Republic of Korea"]},{"name":"Institute of Ewha-SCL for Environmental Health (IESEH), College of Medicine, Ewha Womans University , Seoul 07804 ,","place":["Republic of Korea"]},{"name":"System Health & Engineering Major in Graduate School (BK21 Plus Program), Ewha Womans University , Seoul 07804 ,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2024,7,26]]},"reference":[{"issue":"1","key":"2025042208274164300_dgae449-B1","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s00125-018-4711-2","article-title":"Global trends in diabetes complications: a review of current evidence","volume":"62","author":"Harding","year":"2019","journal-title":"Diabetologia"},{"issue":"2","key":"2025042208274164300_dgae449-B2","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1038\/nrendo.2017.151","article-title":"Global aetiology and epidemiology of type 2 diabetes mellitus and its complications","volume":"14","author":"Zheng","year":"2018","journal-title":"Nat Rev Endocrinol"},{"issue":"1","key":"2025042208274164300_dgae449-B3","doi-asserted-by":"crossref","first-page":"15019","DOI":"10.1038\/nrdp.2015.19","article-title":"Type 2 diabetes mellitus","volume":"1","author":"DeFronzo","year":"2015","journal-title":"Nat Rev Dis Primers"},{"issue":"5","key":"2025042208274164300_dgae449-B4","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/S2213-8587(18)30051-2","article-title":"Novel subgroups of adult-onset diabetes and their association with outcomes: a data-driven cluster analysis of six variables","volume":"6","author":"Ahlqvist","year":"2018","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"1","key":"2025042208274164300_dgae449-B5","doi-asserted-by":"crossref","first-page":"658","DOI":"10.3390\/ijms24010658","article-title":"Current knowledge on the pathophysiology of lean\/normal-weight type 2 diabetes","volume":"24","author":"Salvatore","year":"2022","journal-title":"Int J Mol Sci"},{"issue":"4","key":"2025042208274164300_dgae449-B6","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1016\/j.jdiacomp.2013.11.010","article-title":"Lean versus obese diabetes mellitus patients in the United States minority population","volume":"28","author":"Coleman","year":"2014","journal-title":"J Diabetes Complications"},{"issue":"6","key":"2025042208274164300_dgae449-B7","doi-asserted-by":"crossref","first-page":"1428","DOI":"10.2337\/dc21-1957","article-title":"An atypical form of diabetes among individuals with low BMI","volume":"45","author":"Lontchi-Yimagou","year":"2022","journal-title":"Diabetes Care"},{"issue":"10","key":"2025042208274164300_dgae449-B8","doi-asserted-by":"crossref","first-page":"976","DOI":"10.3390\/ijerph13100976","article-title":"Non-obese diabetes and its associated factors in an underdeveloped area of South China, Guangxi","volume":"13","author":"Tang","year":"2016","journal-title":"Int J Environ Res Public Health"},{"issue":"Supp 1","key":"2025042208274164300_dgae449-B9","first-page":"S40","article-title":"Clinical and biochemical profile of lean type 2 diabetes mellitus","volume":"15","author":"Barma","year":"2011","journal-title":"Indian J Endocrinol Metab"},{"issue":"3","key":"2025042208274164300_dgae449-B10","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.3390\/jcm12031045","article-title":"Being underweight is associated with increased risk of sudden cardiac death in people with diabetes mellitus","volume":"12","author":"Kim","year":"2023","journal-title":"J Clin Med"},{"issue":"3","key":"2025042208274164300_dgae449-B11","first-page":"799","article-title":"Data resource profile: the national health information database of the national health insurance service in South Korea","volume":"46","author":"Cheol Seong","year":"2017","journal-title":"Int J Epidemiol"},{"issue":"4","key":"2025042208274164300_dgae449-B12","doi-asserted-by":"crossref","first-page":"552","DOI":"10.4093\/dmj.2022.0193","article-title":"Current trends of big data research using the Korean National Health Information Database","volume":"46","author":"Kim","year":"2022","journal-title":"Diabetes Metab J"},{"key":"2025042208274164300_dgae449-B13","doi-asserted-by":"crossref","unstructured":"Song DK, Oh JM, Sung Y-A, Hong YS, Lee HJ, Ha EH. 2024. Supplementary Material for All-cause mortality and incidence of cardiovascular diseases in lean patients with newly diagnosed type 2 diabetes. Figshare. Doi: 10.6084\/m9.figshare.26062348.v1","DOI":"10.1210\/clinem\/dgae449"},{"key":"2025042208274164300_dgae449-B14","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.diabres.2018.09.011","article-title":"Ethnic differences in the prevalence of diabetes in underweight and normal weight individuals: the CARRS and NHANES studies","volume":"146","author":"Gujral","year":"2018","journal-title":"Diabetes Res Clin Pract"},{"issue":"4","key":"2025042208274164300_dgae449-B15","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1111\/1753-0407.12213","article-title":"Prevalence and characteristics of non-obese diabetes in Japanese men and women: the Yuport Medical Checkup Center Study","volume":"7","author":"Kashima","year":"2015","journal-title":"J Diabetes"},{"issue":"6","key":"2025042208274164300_dgae449-B16","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1001\/jama.2012.9282","article-title":"Association of weight status with mortality in adults with incident diabetes","volume":"308","author":"Carnethon","year":"2012","journal-title":"JAMA"},{"issue":"3","key":"2025042208274164300_dgae449-B17","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1056\/NEJMoa1304501","article-title":"Body-mass index and mortality among adults with incident type 2 diabetes","volume":"370","author":"Tobias","year":"2014","journal-title":"N Engl J Med"},{"issue":"8","key":"2025042208274164300_dgae449-B18","doi-asserted-by":"crossref","first-page":"e0183235","DOI":"10.1371\/journal.pone.0183235","article-title":"Lean diabetes in middle-aged adults: a joint analysis of the German DIVE and DPV registries","volume":"12","author":"Hartmann","year":"2017","journal-title":"PLoS One"},{"issue":"1","key":"2025042208274164300_dgae449-B19","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1186\/s12933-019-0838-9","article-title":"Weight change and mortality and cardiovascular outcomes in patients with new-onset diabetes mellitus: a nationwide cohort study","volume":"18","author":"Kim","year":"2019","journal-title":"Cardiovasc Diabetol"},{"issue":"1","key":"2025042208274164300_dgae449-B20","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.ijcard.2011.09.039","article-title":"Inverse relation of body weight and weight change with mortality and morbidity in patients with type 2 diabetes and cardiovascular co-morbidity: an analysis of the PROactive study population","volume":"162","author":"Doehner","year":"2012","journal-title":"Int J Cardiol"},{"issue":"1","key":"2025042208274164300_dgae449-B21","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1186\/s12916-019-1355-0","article-title":"Sex differences in the association between diabetes and risk of cardiovascular disease, cancer, and all-cause and cause-specific mortality: a systematic review and meta-analysis of 5,162,654 participants","volume":"17","author":"Wang","year":"2019","journal-title":"BMC Med"},{"issue":"9","key":"2025042208274164300_dgae449-B22","doi-asserted-by":"crossref","first-page":"2582","DOI":"10.2337\/dc12-1272","article-title":"Sex differences in all-cause and cardiovascular mortality, hospitalization for individuals with and without diabetes, and patients with diabetes diagnosed early and late","volume":"36","author":"Roche","year":"2013","journal-title":"Diabetes Care"},{"issue":"2","key":"2025042208274164300_dgae449-B23","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1002\/jcsm.12682","article-title":"Incidence of cardiovascular disease and mortality in underweight individuals","volume":"12","author":"Kwon","year":"2021","journal-title":"J Cachexia Sarcopenia Muscle"},{"issue":"2","key":"2025042208274164300_dgae449-B24","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1002\/jcsm.13417","article-title":"Association between underweight and risk of heart failure in diabetes patients","volume":"15","author":"Yoo","year":"2024","journal-title":"J Cachexia Sarcopenia Muscle"},{"issue":"48","key":"2025042208274164300_dgae449-B25","doi-asserted-by":"crossref","first-page":"e8769","DOI":"10.1097\/MD.0000000000008769","article-title":"Underweight: another risk factor for cardiovascular disease?: a cross-sectional 2013 Behavioral Risk Factor Surveillance System (BRFSS) study of 491,773 individuals in the USA","volume":"96","author":"Park","year":"2017","journal-title":"Medicine (Baltimore)"},{"issue":"16","key":"2025042208274164300_dgae449-B26","doi-asserted-by":"crossref","first-page":"1751","DOI":"10.1177\/2047487319852809","article-title":"Revisiting the obesity paradox in heart failure: per cent body fat as predictor of biomarkers and outcome","volume":"26","author":"Aimo","year":"2019","journal-title":"Eur J Prev Cardiol"},{"issue":"6","key":"2025042208274164300_dgae449-B27","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1007\/s11892-015-0602-9","article-title":"\u0392 cell dysfunction versus insulin resistance in the pathogenesis of type 2 diabetes in East Asians","volume":"15","author":"Yabe","year":"2015","journal-title":"Curr Diab Rep"},{"issue":"2_suppl","key":"2025042208274164300_dgae449-B28","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1177\/2047487319878371","article-title":"Diabetes as a cardiovascular risk factor: an overview of global trends of macro and micro vascular complications","volume":"26","author":"Dal Canto","year":"2019","journal-title":"Eur J Prev Cardiol"}],"container-title":["The Journal of Clinical Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jcem\/advance-article-pdf\/doi\/10.1210\/clinem\/dgae449\/58704011\/dgae449.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/110\/5\/e1547\/58704011\/dgae449.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/110\/5\/e1547\/58704011\/dgae449.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T12:28:15Z","timestamp":1745324895000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/110\/5\/e1547\/7721234"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,26]]},"references-count":28,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,7,26]]},"published-print":{"date-parts":[[2025,4,22]]}},"URL":"https:\/\/doi.org\/10.1210\/clinem\/dgae449","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,5]]},"published":{"date-parts":[[2024,7,26]]}}}