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Obesity Paradox: Comparison of Heart Failure Patients With and Without Comorbid Diabetes

Kyoung Suk Lee1, Debra K Moser2, Terry A Lennie2

  • 1Kyoung Suk Lee is an assistant professor, Chungnam National University, College of Nursing, Dae Jeon, South Korea. Debra K. Moser is a professor, the Gill Endowed Chair of Nursing, and a codirector of the RICH Heart Program, University of Kentucky, College of Nursing, Lexington, Kentucky, and a professor of cardiovascular nursing, University of Ulster, Belfast, Ireland. Terry A. Lennie is a professor and a codirector of the RICH Heart Program, University of Kentucky, College of Nursing. Michele M. Pelter is an assistant professor and Kathleen Dracup is a professor emeritus, University of California San Francisco, School of Nursing, San Francisco, California. Thomas Nesbitt is a professor and associate vice chancellor for strategic technologies and alliances, and Jeffrey A. Southard is an associate clinical professor of medicine, and director of the transcatheter aortic valve replacement program, University of California, Davis, California. kslee14@cnu.ac.kr.

American Journal of Critical Care : an Official Publication, American Association of Critical-Care Nurses
|March 3, 2017
PubMed

Insights

Obesity may improve survival in heart failure patients without diabetes, but this survival benefit is not observed in those with comorbid diabetes. Further research is needed to understand this complex relationship.

Area of Science:

  • Cardiology
  • Endocrinology
  • Public Health

Background:

  • Diabetes is a frequent comorbidity in heart failure (HF) patients, linked to worse outcomes.
  • Obesity is common in HF patients with diabetes and is generally associated with better survival in HF.
  • The impact of diabetes on the obesity-survival relationship in HF is not well understood.

Purpose of the Study:

  • To investigate if the association between body mass index (BMI) and survival differs in heart failure patients with and without diabetes.

Main Methods:

  • A cohort of 560 ambulatory heart failure patients was analyzed.
  • Mean age was 66 years, mean BMI was 32, and 41% had diabetes.
  • Multivariate Cox regression models were used to assess the association between BMI and all-cause mortality.

Main Results:

  • In heart failure patients without diabetes, higher BMI correlated with a reduced risk of all-cause mortality.
  • In heart failure patients with diabetes, BMI was not a significant predictor of all-cause mortality.

Conclusions:

  • Obesity conferred a survival advantage in heart failure patients without diabetes, but not in those with diabetes.
  • The underlying mechanisms for the differential effect of obesity on survival in heart failure patients with comorbid diabetes require further investigation.
Abstract

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