Elderly diabetics with obesity are at higher risk for heart failure: Circulation
USA: Comorbid diabetes and obesity among older adults are related to a greater risk of heart failure (HF), a recent study has revealed. The results, published in the journal Circulation showed that higher waist circumference (WC), body mass index (BMI), and fat mass (FM) are strongly associated with a greater risk of HF in older adults, specifically in those with prevalent diabetes.
Previous studies have shown obesity and diabetes to be associated with a higher risk of heart failure. However, the inter-relationships between different measures of adiposity -- overall obesity, central obesity, FM -- and diabetes status for HF risk are not well-studied. Considering this, Ambarish Pandey, University of Texas Southwestern Medical Center, Dallas, TX, and colleagues aimed to assess the relationship between different adiposity measures, diabetes mellitus, and risk for new HF.
For this purpose, the researchers combined participant-level data from two cohorts using NHLBI BioLINCC. Individuals with prevalent HF were excluded. They then evaluated the population attributable risk of overall obesity (BMI≥30 kg/m2), abdominal obesity (WC>88 and 102 cm in women and men, respectively), and high FM (above sex-specific median) for incident HF among people with and without diabetes.
A total of 10,387 participants (52.9% ARIC; 25.1% diabetes; median age: 74 years) were included.
Based on the study, the researchers found the following:
- The correlation between predicted and bioelectrical impedance-based FM was high.
- Over a 5-year follow-up, 447 participants developed HF (4.3%).
- Higher levels of each adiposity measure were significantly associated with higher HF risk (HR per 1-SD higher BMI=1.19, WC=1.27; FM=1.17).
- A significant interaction was noted between diabetes status and measures of BMI and WC for the risk of HF.
- In stratified analysis, higher measures of each adiposity parameter were significantly associated with higher HF risk in individuals with diabetes (HR per 1-SD higher BMI=1.29, WC=1.48; FM=1.25) but not those without diabetes, including participants with prediabetes and euglycemia.
- The population attributable risk percentage of overall obesity, abdominal obesity, and high FM for incident HF was higher among participants with diabetes (12.8%, 29.9%, 13.7%, respectively) vs. those without diabetes (≤1% for each).
"Our findings showed that higher WC, BMI, and FM are strongly associated with greater risk of HF among older adults, particularly among those with prevalent diabetes," the authors concluded.
Reference:
The study titled, "Diabetes Status Modifies the Association Between Different Measures of Obesity and Heart Failure Risk Among Older Adults: A Pooled Analysis of Community-Based NHLBI Cohorts," was published in the journal Circulation.
