心力衰竭超老患者的肥胖悖论:一个回顾性队列研究
Takahiro Tachibana1, Yoshiaki Kubota2, Takuya Nishino3
1Department of Cardiovascular Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
Heart and vessels
|September 17, 2025
概括
肥胖悖论,即更高的体重改善了结果,在超级老年心力衰竭患者中得到证实. 体重不足的人面临更高的死亡率,特别是由于心脏原因,突出显示BMI.
科学领域:
- 心脏病学 心脏病学
- 老年病的医生 老年病的医生
- 公共卫生 公共卫生
背景情况:
- 肥胖是心力衰竭 (HF) 发病的危险因素,但体重减轻与HF患者的预后不佳有关.
- 肥胖悖论表明,更高的体重与HF患者的更好的结果有关.
- 超级老年人群 (≥85岁) 对于心力衰竭中肥胖悖论的研究仍然不足.
研究的目的:
- 研究心力衰竭 (HF) 的超老年患者 (≥85岁) 的肥胖悖论.
- 检查身体质量指数 (BMI) 对各种原因死亡率在不同年龄组的HF患者的影响.
- 评估BMI与心脏/非心脏死亡率之间的关系,按左心室喷射率 (LVEF) 分层.
主要方法:
- 这是一项回顾性队列研究,包括2015年4月至2023年3月期间因HF住院的3811名患者.
- 参与者分为四个年龄组:<65,65-74,75-84岁和≥85岁.
- 主要终点:一年全因死亡率;次要终点:心脏/非心脏死亡率和根据LVEF分层的死亡率.
主要成果:
- 在所有年龄组的体重不足患者 (BMI <18.5 kg/m2) 中,观察到更高全因死亡率的趋势.
- 患有肥胖症 (BMI ≥25.0 kg/m2) 的患者表现出明显更好的生存率.
- 体重不足与心脏病死亡率的增加有关,特别是在超级老年人 (D组) 和具有保存LVEF的HF患者中.
结论:
- 肥胖悖论在超级老年人心力衰竭人口中得到证实.
- 体重不足是心力衰竭患者死亡率,特别是心脏病死亡率的重要预测因素.
- 身体质量指数 (BMI) 是在所有年龄组心力衰竭的管理和预后评估中需要考虑的关键因素.
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