代谢性超重/肥胖表型与慢性心力衰竭患者死亡风险之间的关联
You Zhou1, Yingli Xie2, Jingjing Dong2
1School of Medicine, Nankai University, Tianjin, China.
Frontiers in endocrinology
|October 7, 2024
概括
代谢综合征在男性和老年女性中增加心力衰竭死亡风险,而超重/肥胖在年轻女性中具有保护作用. 这些代谢因素与基于性别和年龄的慢性心力衰竭预后有不同的相互作用.
科学领域:
- 心脏病学 心脏病学
- 代谢障碍 代谢障碍 代谢障碍
- 肥胖问题研究研究
背景情况:
- 代谢障碍和肥胖在慢性心力衰竭 (CHF) 中很常见.
- 考虑到年龄和性别,这些疾病对心血管疾病预后的相互作用影响尚不清楚.
研究的目的:
- 调查代谢综合征和体重指数 (BMI) 对心血管疾病患者预后的综合影响.
- 探索年龄和性别是否影响代谢状态,BMI和心力衰竭结果之间的关系.
主要方法:
- 4,955名CHF患者被分为四种表型:代谢健康的正常体重 (MHNW),代谢不健康的正常体重 (MUNW),代谢健康的超重/肥胖 (MHO) 和代谢不健康的超重/肥胖 (MUO).
- 代谢状态是由代谢综合征 (MetS) 的存在决定的,BMI类别是正常体重 (<24 kg/m2),超重/肥胖 (≥24 kg/m2).
- 记录和分析了所有原因和心血管 (CV) 死亡的发生率,使用Cox比例风险模型.
主要成果:
- 与MHNW相比,MUNW和MUO表型显示所有原因死亡风险增加 (aHR分别为1.66和1.42).
- 在MHO表型中,所有死因死亡风险降低 (aHR为0.61).
- 这些关联主要在男性和老年女性 (≥60岁) 中观察到;然而,在非老年女性 (<60岁) 中,不论代谢状态如何,超重/肥胖都会给予保护.
结论:
- 在男性和老年女性CHF患者中,代谢综合征的不良影响超过了超重/肥胖的好处.
- 在非老年女性中,超重/肥胖对不良CHF结局提供了显著的保护,超过了代谢综合征的影响.
- 代谢健康,体重状况和CHF预后之间的相互作用取决于性别和年龄.
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