Obesity measures strongly linked to heart failure risk in diabetes patients
USA: Higher waist circumference, fat mass, and body mass index (BMI) is strongly related to the risk of heart failure (HF) in older adults, particularly in those with prevalent diabetes, a recent study has found. The study appears in Circulation, the journal of the American Heart Association (AHA).
Diabetes and obesity are known to be associated with a higher risk of heart failure. However, the inter-relationships between different measures of adiposity—overall obesity, fat mass, central obesity -- and diabetes status for HF risk are not well-established. To establish a certain link between them, Kershaw V. Patel, Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, and colleagues conducted this study.
The researchers obtained participant-level data from ARIC(visit-5) and CHS(visit-1) cohorts from the NHLBI BioLINCC, harmonized, and pooled for the present analysis. Individuals with prevalent HF were excluded. Using anthropometric prediction equations, FM was estimated in all participants. Incident HF events on follow-up were captured across both cohorts. The associations between BMI, WC, and FM with HF risk were evaluated in the overall cohort as well as among those with vs. without diabetes at baseline.
The researchers also evaluated 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 participants with and without diabetes.
The study included 10,387 participants (52.9% ARIC; 25.1% diabetes; median age: 74 years).
Key findings include:
- The correlation between predicted and bioelectrical impedance-based FM was high (R2=0.90; n=5,038).
- 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).
The researchers concluded, "In older adults, higher body mass index (BMI), waist circumference (WC), and fat mass (FM) were identified to be strongly linked with greater risk of heart failure (HF), especially in those with prevalent diabetes."
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.
