Inspecting the association between metabolic obese phenotypes and heart failure subtypes risk

Area of Science:

• Cardiology
• Metabolic Health
• Epidemiology

Background:

• Obesity and metabolic dysfunction are distinct, yet their combined impact on heart failure (HF) subtypes remains unclear.
• Understanding these relationships is crucial for targeted prevention and treatment strategies.

Purpose of the Study:

• To investigate the association between distinct metabolic obese phenotypes and the future risk of developing specific heart failure subtypes.
• To analyze how transitions between phenotypes over time influence heart failure risk.

Main Methods:

• Utilized data from 9791 participants in the ARIC study.
• Classified participants into four phenotypes: metabolically healthy non-obesity (MHNO), metabolically healthy obesity (MHO), metabolically unhealthy non-obesity (MUNO), and metabolically unhealthy obesity (MUO).
• Employed Cox regression models to assess the risk of HF with preserved ejection fraction (HFpEF) and HF with reduced or mid-range ejection fraction (HFrEF/HFmrEF).

Main Results:

• Compared to MHNO, MHO, MUNO, and MUO phenotypes were associated with increased HFpEF risk.
• MUNO and MUO phenotypes showed increased risk for HFrEF/HFmrEF.
• Associations were more pronounced in individuals younger than 55 and females. Persistent unhealthy phenotypes (MHO, MUNO, MUO) elevated HFpEF risk, and transitions to MUO increased risk for all HF subtypes.

Conclusions:

• Metabolically unhealthy non-obesity (MUNO) and metabolically unhealthy obesity (MUO) are linked to increased risk across all heart failure subtypes.
• Metabolically healthy obesity (MHO) is specifically associated with an increased risk of HFpEF, but not HFrEF/HFmrEF.