{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T21:05:08Z","timestamp":1790888708918,"version":"4.1.0"},"reference-count":35,"publisher":"Korean Diabetes Association","issue":"5","license":[{"start":{"date-parts":[[2022,5,10]],"date-time":"2022-05-10T00:00:00Z","timestamp":1652140800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82173607"],"award-info":[{"award-number":["82173607"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100021171","name":"Guangdong Basic and Applied Basic Research Foundation","doi-asserted-by":"crossref","award":["2021A1515011684"],"award-info":[{"award-number":["2021A1515011684"]}],"id":[{"id":"10.13039\/501100021171","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Open Project of the Guangdong Provincial Key Laboratory of Tropical Disease Research","award":["2020B1212060042"],"award-info":[{"award-number":["2020B1212060042"]}]},{"name":"Guangzhou Science and Technology Project","award":["202102080597"],"award-info":[{"award-number":["202102080597"]}]}],"content-domain":{"domain":["e-dmj.org"],"crossmark-restriction":true},"short-container-title":["Diabetes Metab J"],"published-print":{"date-parts":[[2022,9,30]]},"abstract":"<jats:p>Background: Obesity is associated with adverse health events among diabetic patients, however, the relationship between obesity fluctuation and risk of microvascular complications among this specific population is unclear. We aimed to examine the effect of waist circumference (WC) and body mass index (BMI) variability on the risk of diabetic microvascular outcomeMethods: Annually recorded anthropometric data in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study was used to examine the association of WC and BMI variability defined as variability independent of mean, with the risk of microvascular outcomes, including neuropathy, nephropathy, and retinopathy. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) (Trial registration: ClinicalTrials.gov., no. NCT00000620).Results: There were 4,031, 5,369, and 2,601 cases of neuropathy, nephropathy, and retinopathy during a follow-up period of 22,524, 23,941, and 23,850 person-years, respectively. Higher levels of WC and BMI variability were associated with an increased risk of neuropathy. Compared with the lowest quartile, the fully-adjusted HR (95% CI) for the highest quartile of WC and BMI variability for neuropathy risk were 1.21 (1.05 to 1.40) and 1.16 (1.00 to 1.33), respectively. Also, higher quartiles of BMI variability but not WC variability were associated with increased risk of nephropathic events. The fully-adjusted HR (95% CI) for the highest quartile compared with the lowest quartile of BMI variability was 1.31 (1.18 to 1.46). However, the results for retinopathic events were all insignificant.Conclusion: Among participants with type 2 diabetes mellitus, WC and BMI variability were associated with a higher risk of neuropathic events, whereas BMI variability was associated with an increased risk of nephropathic events.<\/jats:p>","DOI":"10.4093\/dmj.2021.0258","type":"journal-article","created":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T19:37:36Z","timestamp":1652902656000},"page":"767-780","update-policy":"https:\/\/doi.org\/10.4093\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Waist Circumference and Body Mass Index Variability and Incident Diabetic Microvascular Complications: A Post Hoc Analysis of ACCORD Trial"],"prefix":"10.4093","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7017-0449","authenticated-orcid":true,"given":"Daniel Nyarko","family":"Hukportie","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0399-7489","authenticated-orcid":true,"given":"Fu-Rong","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia-Zhen","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6363-1916","authenticated-orcid":true,"given":"Xiao-Xiang","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2706-9599","authenticated-orcid":true,"given":"Xian-Bo","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2567","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.2337\/dc17-1962"},{"key":"ref2","volume-title":""},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1038\/s41433-019-0352-z"},{"key":"ref4","first-page":"S135","volume-title":"11","year":"2020"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2008.05.014"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1111\/1753-0407.13075"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.11-7208"},{"key":"ref8","first-page":"761","volume-title":"Association of obesity with inflammation in occult chronic kidney disease","author":"Bavbek","year":"2008"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1161\/01.hyp.0000094221.86888.ae"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmet.2016.02.005"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1053\/j.jrn.2014.01.016"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1007\/s13679-017-0262-y"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1002\/oby.21398"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1038\/ijo.2010.131"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1161\/circoutcomes.118.004724"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.2337\/dc19-2552"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2018.11.016"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ijo.0801359"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcg069"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2014.10.039"},{"key":"ref21","volume-title":"ACCORD: ACCORDION: the ACCORD follow-on study protocol (March 18, 2011\u2013Version G)","year":"2011"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2007.03.003"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1159\/000446122"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2016.4828"},{"key":"ref25","volume-title":""},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa1606148"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2018.10.012"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.3803\/enm.2020.871"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2021-002123"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2018.10.019"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-019-01453-7"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1016\/j.oret.2020.09.003"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-021-01289-4"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1016\/j.acra.2013.08.012"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2009.252"}],"container-title":["Diabetes &amp; Metabolism Journal"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/e-dmj.org\/upload\/pdf\/dmj-2021-0258.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-dmj.org\/journal\/view.php?doi=10.4093\/dmj.2021.0258","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-dmj.org\/upload\/pdf\/dmj-2021-0258.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,25]],"date-time":"2022-09-25T20:40:23Z","timestamp":1664138423000},"score":1,"resource":{"primary":{"URL":"http:\/\/e-dmj.org\/journal\/view.php?doi=10.4093\/dmj.2021.0258"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,30]]},"references-count":35,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2022,9]]}},"URL":"https:\/\/doi.org\/10.4093\/dmj.2021.0258","relation":{"is-referenced-by":[{"id-type":"doi","id":"10.1186\/s13098-026-02157-5","asserted-by":"object"}]},"ISSN":["2233-6079","2233-6087"],"issn-type":[{"value":"2233-6079","type":"print"},{"value":"2233-6087","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,30]]},"assertion":[{"value":"2021-09-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-01-14","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-05-10","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-30","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}