Waist Circumference, Body Mass Index, and Survival in Systolic Heart Failure: The Obesity Paradox Revisited
Waist Circumference, Body Mass Index, and Survival in Systolic Heart Failure: The Obesity Paradox Revisited
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DOI：
10.1016/j.cardfail.2011.01.009
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发表时间：
2011-05-01
影响因子：
6
通讯作者：
Horwich, Tamara B.
中科院分区：
文献类型：
--
作者：
Clark, Adrienne L.;Fonarow, Gregg C.;Horwich, Tamara B.
背景资料：较高的体重指数（BMI）与改善心力衰竭（HF）的生存率，但腰围（WC）在HF outcomes的作用还没有studied.Methods和结果：共344例晚期收缩期HF患者WC和BMI测量在介绍。高WC定义为女性>= 88 cm，男性>= 102 cm，高BMI定义为>= 25 kg/m2。高WC组与正常WC组的两年紧急心脏移植（UT）无存活率分别为77.9%与64.3%（P = 0.025），高BMI组与正常BMI组的两年紧急心脏移植无存活率分别为89.8%与58.2%（P <0.001）。多变量校正后，正常WC与高WC相比，与更高的全因死亡率（风险比[RR] 2.76，95%置信区间[CI] 1.34-5.71）和更高的死亡/UT风险（RR 2.14，95% CI 1.25-3.68）相关。最好的结果是在那些高WC和高BMI.Conclusions：高WC，一个替代的人体测量指标的肥胖更具体的腹部肥胖，高BMI，高WC/高BMI的组合，每个与改善的结果在这个先进的HF队列，借贷进一步支持HF的肥胖悖论。身体成分在HF生存中的作用应该是未来研究的重点。（J Cardiac Fail 2011;17：374-380）
Background: Higher body mass index (BMI) is associated with improved heart failure (HF) survival, but the role of waist circumference (WC) in HF outcomes has not been studied.Methods and Results: A total of 344 patients with advanced systolic HF had WC and BMI measured at presentation. High WC was defined as >= 88 cm in women and >= 102 cm in men, and high BMI as >= 25 kg/m(2). Two-year urgent heart transplant (UT) free survival in high vs normal WC groups was 77.9% vs 64.3% (P = .025) and in high vs normal BMI was 89.8% vs 58.2% (P < .001). After multivariable adjustment, normal WC compared with high WC was associated with higher all-cause mortality (risk ratio [RR] 2.76, 95% confidence interval [CI] 1.34-5.71) and higher risk of death/UT (RR 2.14, 95% CI 1.25-3.68). The best outcomes were seen in those with both high WC and high BMI.Conclusions: High WC, an alternative anthropometric index of obesity more specific to abdominal adiposity, high BMI, and the combination of high WC/high BMI were each associated with improved outcomes in this advanced HF cohort, lending further support for an obesity paradox in HF. The role of body composition in HF survival should be a focus of future investigation. (J Cardiac Fail 2011;17:374-380)