Body Mass Index

Study of Twins Links High BMI with Increased Risk of Type 2 Diabetes

by Barbara Hewitt on August 2, 2016

Having a higher Body Mass Index (BMI) is associated with an increased risk of type 2 diabetes, but not of heart attack or death, new research into identical twins has found.

Researchers at Umeå University in Sweden compared health data from 4,046 monozygotic twin pairs. All twins in the study had different levels of body fat, as measured in BMI – a well-recognised measure of obesity.

lab-microscopeTwins were studied between 1998 and 2003 and then followed for an average of 12.4 years. Researchers examined differences in incidents of mortality, heart attack and type 2 diabetes. The results clearly showed that twin siblings with a higher BMI did not have an increased risk of mortality or heart attack compared to their thinner counterparts, but did have an increased risk of developing type 2 diabetes.

Genetically identical siblings with different BMI provide researchers with a unique opportunity to evaluate obesity related health risks that are independent of genetic factors.

Breaking down the results, twin siblings with a higher BMI (mean value 25.1) suffered 203 heart attacks (5 %) and 550 deaths (13.6 %) during the follow-up period, while twins with a lower BMI (mean value 23.9) suffered 209 heart attacks (5.2 %) and 633 deaths (15.6 %).

Among the 65 twin pairs in the study who had a BMI difference of 7 or higher, and where the larger twin siblings registered a BMI of 30 or higher, there were still no noticeable increase in the risk of mortality or heart attack associated with the higher BMI.

‘The results suggest that lifestyle changes that reduce levels of obesity do not have an effect on the risk of death and heart attack, which contradicts conventional understandings of obesity-related health risks,’ said Peter Nordström, researcher at the Department of Community Medicine and Rehabilitation at Umeå University.

‘What the study does show is that there’s a strong association between obesity and diabetes, which leads us to conclude that weight reduction interventions can be more effective against diabetes than when it comes to reducing the risk of heart attack and mortality,’ he added.

The study is based on the Swedish Twin Registry, the largest of its kind in the world. The median age of the twins in the study was 57.5 and participants’ ages ranged from 42 to 92. Follow-ups regarding incident of mortality, heart attack and diabetes took place over a 10 year period lasting until 2013. One study limitation was that weight and length used to calculate BMI was self-reported.

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