Association of metabolically healthy obesity with risk of heart failure and left ventricular dysfunction among older adults

IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM International Journal of Obesity Pub Date : 2024-10-09 DOI:10.1038/s41366-024-01587-3
Peng Wang, Menghui Liu, Shaozhao Zhang, Yue Guo, Zhenyu Xiong, Yiquan Huang, Xiaojie Cai, Lixiang He, Zhuohui Chen, Yi Zhou, Xiaodong Zhuang, Xinxue Liao
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Abstract

Obesity is major cause of heart failure (HF), but it is related with a better prognosis among the elderly. Therefore, we aimed to examine whether metabolically healthy obesity (MHO) in late life increases HF risk and is reflected in impaired left ventricular (LV) function. The participants were grouped into four metabolic phenotypes based on obesity and metabolic status: metabolically healthy non-obesity (MHN), MHO, metabolically unhealthy non-obesity (MUN), metabolically unhealthy obesity (MUO). Association of metabolic phenotypes with LV function was evaluated using multiple linear regression models. And association between metabolic phenotypes and risk of HF was assessed using multivariable logistic regression models. In addition, we validated the association of metabolic phenotypes and HF risk in a separate longitudinal cohort. In the primary cohort of 6335 participant, there were 434 participants diagnosed with HF. Compared to MHN participants, the risk of HF was higher among older individuals with MUN (OR = 1.51 [95% CI: 1.14–1.99]) and MUO (OR = 2.01 [95% CI: 1.39–2.91]), but not older individuals with MHO (OR = 0.86 [95% CI: 0.30–2.43). Regarding to LV function, worse LV diastolic function was noted among MUN and MUO individuals rather than MHO individuals. Older adults with MHO were also not associated with risk of HF in the validation cohort. Among older individuals, the metabolic health status might modify the association of obesity with risk of HF and LV diastolic dysfunction. Worse LV diastolic function and higher risk of HF were just noted in individuals with MUO, but not in those with MHO.

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代谢健康的肥胖与老年人心力衰竭和左心室功能障碍风险的关系。
背景:肥胖是导致心力衰竭(HF)的主要原因,但它与老年人较好的预后有关。因此,我们旨在研究晚年代谢健康型肥胖(MHO)是否会增加心力衰竭风险,并反映在左心室(LV)功能受损上:根据肥胖和代谢状况将参与者分为四种代谢表型:代谢健康非肥胖(MHN)、MHO、代谢不健康非肥胖(MUN)、代谢不健康肥胖(MUO)。代谢表型与左心室功能的关系采用多元线性回归模型进行评估。使用多变量逻辑回归模型评估了代谢表型与心房颤动风险之间的关系。此外,我们还在一个单独的纵向队列中验证了代谢表型与心房颤动风险之间的关联:在主要队列的 6335 名参与者中,有 434 人确诊为高血压。与MHN参与者相比,患有MUN(OR = 1.51 [95% CI: 1.14-1.99])和MUO(OR = 2.01 [95% CI: 1.39-2.91])的老年人患心房颤动的风险更高,但患有MHO(OR = 0.86 [95% CI: 0.30-2.43)的老年人患心房颤动的风险则不高。在左心室功能方面,MUN和MUO患者的左心室舒张功能比MHO患者差。在验证队列中,患有MHO的老年人也与罹患HF的风险无关:结论:在老年人中,代谢健康状况可能会改变肥胖与心房颤动和左心室舒张功能障碍风险的关系。MUO患者的左心室舒张功能较差,患心房颤动的风险较高,而MHO患者的左心室舒张功能较差,患心房颤动的风险较低。
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来源期刊
International Journal of Obesity
International Journal of Obesity 医学-内分泌学与代谢
CiteScore
10.00
自引率
2.00%
发文量
221
审稿时长
3 months
期刊介绍: The International Journal of Obesity is a multi-disciplinary forum for research describing basic, clinical and applied studies in biochemistry, physiology, genetics and nutrition, molecular, metabolic, psychological and epidemiological aspects of obesity and related disorders. We publish a range of content types including original research articles, technical reports, reviews, correspondence and brief communications that elaborate on significant advances in the field and cover topical issues.
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