Body Mass Index, Cardiometabolic Treatment Patterns and Multifactorial Risk‐Factor Control in Chinese Adults With Type 2 Diabetes: A Multicenter Cross‐Sectional Study

Background

To examine medication use and simultaneous achievement of glycemic, blood pressure and lipid targets across body mass index (BMI) categories in Chinese adults with Type 2 diabetes.

Methods

This BMI‐focused secondary cross‐sectional analysis included 8590 adults with evaluable BMI recruited from 60 hospitals in the iCaReMe China Registry. The primary comparison was obesity versus normal weight for simultaneous achievement of HbA1c < 7.0%, blood pressure < 130/80 mmHg and LDL cholesterol < 2.6 mmol/L. Missing data were handled by multiple imputation (20 datasets; 20 iterations per chain), and associations were estimated with center‐clustered generalized estimating equations (GEE).

Results

The cohort comprised 99 (1.2%) adults with underweight, 2725 (31.7%) normal weight, 3663 (42.6%) overweight, and 2103 (24.5%) obesity. Among 6683 with all three observed components, 332 (5.0%) achieved the composite. Compared with normal weight, the pooled adjusted OR for obesity was 0.55 (95% CI 0.39–0.78); each 1‐kg/m ² higher BMI was associated with an OR of 0.93 (0.90–0.96). For obesity, component‐specific ORs were 0.72 (0.61–0.85) for HbA1c, 0.47 (0.40–0.55) for blood pressure and 1.05 (0.91–1.22) for LDL‐C. Sensitivity analyses supported the composite finding, with no evidence of nonlinearity ( p  = 0.904).

Conclusions

Obesity was associated with lower odds of simultaneous target attainment, with component‐specific associations for glycemia and blood pressure but not LDL‐C. GLP‐1 receptor agonists and SGLT2 inhibitors were used more often at higher BMI; these prescribing patterns do not establish treatment effectiveness.

Trial Registration: ChiCTR2300073764.