Ann Geriatr Med Res 2017; 21(2): 70-77  http://dx.doi.org/10.4235/agmr.2017.21.2.70
Weight Status and All-Cause Mortality in Older Adults: A Study of Patients With Type 2 Diabetes Undergoing Subtotal Gastrectomy for Cancer
Yeongkeun Kwon1,2, Kyeong Jin Kim2,3, Yong Kyun Roh4, Yong-Gyu Park5, Sungsoo Park2,6, Kyung-Hwan Cho1
1Division of Geriatrics, Department of Family Medicine, Korea University College of Medicine, Seoul, 2Center for Obesity and Metabolic Diseases, Korea University Anam Hospital, Seoul, 3Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, 4Department of Family Medicine, Hallym University College of Medicine, Chuncheon, 5Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, 6Division of Upper Gastrointestinal Surgery, Department of Surgery, Korea University College of Medicine, Seoul, Korea
Correspondence to: Kyung-Hwan Cho, MD, MPH, PhD
Division of Geriatrics, Department of Family Medicine, Korea University College of Medicine, Inchon-ro 73, Seongbuk-gu, Seoul 02841, Korea
Tel: +82-2-920-5105 Fax:+82-2-928-8083 E-mail: chokh@korea.ac.kr
Sungsoo Park, MD, PhD
Division of Upper Gastrointestinal Surgery, Department of Surgery, Korea University College of Medicine, Inchon-ro 73, Seongbuk-gu, Seoul 02841, Korea
Tel: +82-2-920-6772 Fax:+82-2-928-1631 E-mail: kugspss@korea.ac.kr
Received: April 19, 2017; Revised: June 9, 2017; Accepted: June 11, 2017; Published online: June 30, 2017.
© The Korea Geriatrics Society. All rights reserved.

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: The survival benefit of excess body weight is controversial across various subpopulations. We assessed the effect of weight status on all-cause mortality among patients with type 2 diabetes (T2DM) undergoing subtotal gastrectomy for gastric cancer. Methods: Medical charts of 210 patients with T2DM treated at 2 university hospitals were examined retrospectively. All patients had undergone subtotal gastrectomy for cancer between January 1993 and December 2012. Participants were categorized as normal weight (body mass index [BMI], 18.5-24.99 kg/m2) or overweight/obese (BMI≥25 kg/m2). The association between weight status and all-cause mortality was assessed using weighted Cox proportional hazard regression models and inverse probability weighting. Results: The mortality rate was 25.2% after a median follow-up duration of 6.1 years (interquartile range, 3.5-8.3 years; maximum, 14.4 years). The overweight/obese group had a significantly lower risk of all-cause mortality (hazard ratio, 0.51; 95% confidence interval, 0.34-0.77; p=0.001) compared with the normal weight group. Overweight/obesity was associated with reduced all-cause mortality in patients aged <65 years (p=0.01 for interaction). Conclusion: Among T2DM patients who underwent subtotal gastrectomy for cancer, only the subgroup of patients aged <65 years in the overweight/obese group showed reduced allcause mortality compared with the normal weight group.
Keywords: Type 2 diabetes, Body mass index, Subtotal gastrectomy, Stomach neoplasms, Mortality


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