Sarcopenic Obesity Increases Risk of Heart Failure Progression in Diabetes, finds study

Key Findings

• The patients with SO had profoundly elevated amino-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and greater hypoproteinemia than non sarcopenic obese patients.

• The patients with SO had more LV expansion, elevated LV mass, and more severe LV dysfunction, reflecting negative cardiac remodeling.

• In follow-up, 73 patients (25.8%) had adverse cardiovascular outcomes, and the most unfavorable prognosis was in the SO group (log-rank p= 0.04).

• Multivariable Cox regression analysis revealed that patients with SO were 3.03 times more likely to have adverse outcomes than those without sarcopenia or obesity (HR: 3.03, 95% CI: 1.39–6.63, p= 0.005).

The study authors concluded that SO is an independent predictor of negative cardiovascular outcomes in diabetic HFrEF patients. As a result of its close correlation with adverse LV remodeling and increased mortality risk, SO should be acknowledged as an important determinant in risk stratification and specific management approaches in these patients.

Reference:

Shi, K., Zhang, G., Xu, R. et al. Association of body composition with left ventricular remodeling and outcomes in diabetic heart failure with reduced ejection fraction: assessment of sarcopenic obesity using cardiac MRI. Cardiovasc Diabetol 24, 79 (2025). https://doi.org/10.1186/s12933-025-02639-2