Yonsei Med J.  2018 Jan;59(1):57-62. 10.3349/ymj.2018.59.1.57.

Is There a Sex-Related Difference in the Obesity Paradox in Systolic Heart Failure? Sex-Related Difference in the Obesity Paradox

• Hong S
• Lee JH
• Kim KM
• Lee JW
• Youn YJ
• Ahn MS
• Ahn SG
• Lee SH
• Yoon J
• Choe KH
• Yoo BS

• KMID: 2418849
• DOI: http://doi.org/10.3349/ymj.2018.59.1.57

Abstract

PURPOSE
Obesity is often associated with better clinical outcomes in heart failure (HF). This so-called obesity paradox remains controversial. The aim of present study was to investigate the prognostic value of obesity in patients hospitalized for systolic HF.
MATERIALS AND METHODS
We performed a pooled analysis of data from two multicenter, observational HF studies. Patients hospitalized for systolic HF were eligible for the present study. We divided the subjects into two groups, a normal body mass index (BMI) group and a high BMI group. Study endpoints included all-cause mortality and any re-hospitalization within 1 year.
RESULTS
We enrolled 3145 patients (male, 1824; female, 1321). The high BMI group was significantly associated with lower 1-year mortality rate [odds ratio (OR), 0.543; 95% confidence interval (CI), 0.355−0.832] after adjusting for age, hypertension, diabetes, ischemic HF, previous myocardial infarction, serum creatinine level, anemia, and ejection fraction in men. After adjustment for clinical characteristics, high BMI was not significantly associated with 1-year mortality (OR, 0.739; 95% CI, 0.450−1.216) or 1-year re-hospitalization (OR, 0.958; 95% CI, 0.696−1.319) in women.
CONCLUSION
In pooled analysis of data from two Korean HF registries, the high BMI group was independently associated with lower 1-year mortality rate from systolic HF, especially in men.

Keyword

Obesity; heart failure; systolic; sex difference

MeSH Terms

Aged
Body Mass Index
Demography
Endpoint Determination
Female
Heart Failure, Systolic/*complications/*epidemiology
Humans
Incidence
Kaplan-Meier Estimate
Male
Middle Aged
Obesity/*complications/*epidemiology
*Sex Characteristics
Treatment Outcome

Figure

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  Fig. 1 Selection of study population. KorHF, The Korean Heart Failure registry; SUGAR, Survey of Guideline Adherence for Treatment of Systolic Heart Failure in Real World; LVEF, left ventricular ejection fraction; BMI, body mass index.

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  Fig. 2 Kaplan-Meier curve for incidence of the primary endpoint in the male population. BMI, body mass index.

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  Fig. 3 Kaplan-Meier curve for incidence of the primary endpoint in the female population. BMI, body mass index.

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