Skip Navigation LinksHome > January 2014 - Volume 25 - Issue 1 > Body Mass Index, Diabetes, and Mortality in French Women: Ex...
doi: 10.1097/EDE.0000000000000031

Body Mass Index, Diabetes, and Mortality in French Women: Explaining Away a “Paradox”

Lajous, Martina,b,c; Bijon, Annec,d; Fagherazzi, Guyc,d; Boutron-Ruault, Marie-Christinec,d; Balkau, Beverleyc,d; Clavel-Chapelon, Françoisec,d; Hernán, Miguel A.a,e,f

Supplemental Author Material
Collapse Box


Background: Obesity is associated with increased mortality in the general population but, paradoxically, with decreased mortality in persons with diabetes.

Methods: Among 88,373 French women participating in the E3N-EPIC study who were free of diabetes in 1990, we estimated the hazard ratios (HRs) and 95% confidence intervals (CIs) of mortality for body mass index (BMI) levels by diabetes status.

Results: During an average 16.7 years of follow-up, 2421 cases of diabetes were identified and 3750 deaths occurred. For overweight/obese versus normal-weight women, the HR of mortality was 1.42 (95% CI = 1.32–1.53) in women without diabetes and 0.69 (0.40–1.18) in women with incident diabetes. As BMI increased, mortality among women without diabetes increased and that among women with diabetes decreased.

Conclusions: We found the obesity “paradox” among women with and without incident diabetes in the same population. Selection bias may be a simple explanation for this “paradox.”

© 2014 by Lippincott Williams & Wilkins, Inc

Twitter  Facebook 


Article Tools


Article Level Metrics