Article

OBJECTIVES: To examine the association between body mass index (BMI) and
clinically diagnosed diabetes in veterans with spinal cord injuries and
disorders. We also sought to determine whether there is evidence to support a 10%
reduction in BMI cut points, which would lower the upper limit of normal BMI from
24.99 to 22.49 kg/m, for persons with spinal cord injuries and disorders. DESIGN:
Cross-sectional analysis using clinical data on 1938 male veterans. Prevalence
ratios (95% confidence intervals) were calculated using a generalized linear
model and adjusted for age, race, tobacco use, and paraplegia/tetraplegia status.
RESULTS: Compared with the National Heart Lung Blood Institute normal BMI
category (18.5-24.99 kg/m), the prevalence of diabetes was 50% higher (adjusted
prevalence ratio: 1.50, 95% CI: 1.11-2.01) in the overweight category (25-29.99
kg/m) and approximately 3-fold higher (for obese classes 1-3, adjusted prevalence
ratio: 2.74-3.03) in the obese category (BMI >or= 30 kg/m). Compared with the
World Health Organization low-normal category (BMI, 18.5-22.99 kg/m), there was
no significant difference in the prevalence of diabetes for those in the high
normal weight (BMI, 23-24.99 kg/m) or low overweight (BMI, 25-27.49 kg/m)
categories. However, the prevalence of diabetes was 2-fold higher among those in
the high overweight category (BMI, 27.5-29.99 kg/m; adjusted prevalence ratio:
2.00, 95% CI: 1.33-2.99). CONCLUSIONS: BMI >or=25 kg/m was associated with
significantly higher diabetes prevalence in male veterans with spinal cord
injuries and disorders, and this risk was especially pronounced at BMI >or=27.5
kg/m. These findings do not support the need to create spinal cord injuries and
disorder-specific BMI definitions of overweight for purposes of determining
diabetes risk.

Langue : ANGLAIS