ArticleJournal of cachexia, sarcopenia and muscle2026
Underweight Versus Obesity and Gastrointestinal Cancer Mortality in Type 2 Diabetes: A Nationwide Cohort Study.
Article in Journal of cachexia, sarcopenia and muscle, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundUnderweight is a well-established risk factor for cancer mortality, yet its impact relative to obesity remains unclear in individuals with type 2 diabetes mellitus (T2DM), where current guidelines focus primarily on obesity management with limited guidance on underweight-related risks. We evaluated the association between body mass index (BMI) and gastrointestinal (GI) cancer mortality across the full BMI spectrum in individuals with T2DM.
methodsThis nationwide population-based cohort study utilized the Korean National Health Insurance Service database. We included 2 507 976 adults with T2DM screened in 2015-2016 and followed through 2022, with a 1-year lag period applied to minimize reverse causality. BMI was categorized into eight groups: severe underweight (< 16.0 kg/m
resultsDuring 5.75-year mean follow-up, 10 978 GI cancer deaths occurred (975 oesophageal, 4391 gastric, 5317 colorectal and 295 other GI cancers including small intestine and anal cancer). A reverse J-shaped association was observed with mortality nadir at BMI 25.0-29.9 kg/m
conclusionsIn individuals with T2DM, underweight status is associated with substantially higher GI cancer mortality risk than obesity, with severe underweight showing nearly threefold higher risk compared to the reference group (BMI 25.0-29.9 kg/m
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