Influences of body mass index and waist circumference on physical function in older persons with heart failure

Introducción: La obesidad y la adiposidad están relacionadas con el aumento del riesgo cardiovascular. El índice de masa corporal (IMC) y el perímetro abdominal son las variables antropométricas más utilizadas para evaluar su magnitud. El presente estudio busca establecer la relación entre desenlaces cardiometabólicos y la adiposidad medida con Absorciometría Dual por rayos X (DXA), así como el rendimiento diagnóstico de la misma contra la medición de las variables antropométricas convencionales. Materiales y métodos: Se realizó un estudio observacional de corte transversal; se calcularon las variables antropométricas y de composición corporal para 60 pacientes en programa de rehabilitación cardiaca fase II. Resultados: Existió mayor prevalencia de obesidad por IMC y adiposidad en mujeres que en hombres (p=0,01 y 0,048). La curva ROC encontró que el rendimiento del perímetro abdominal es solo 65% y el del IMC del 65,6% para el diagnóstico de adiposidad. Se encontraron relaciones significativas entre porcentaje de masa grasa elevado y la enfermedad coronaria (OR: 1,9 p= 0,042); el IMC aumentado con la hipertensión arterial (OR: 3,0 p= 0,0334) y el LDL > 70 mg/dl (OR: 0,4 p= 0,0178); el perímetro abdominal aumentado con la falla cardiaca (OR: 0,58 p=0,0382); la TMB baja con la hipertensión arterial (OR: 1,70 p= 0,046) y finalmente el IIRME disminuido con el LDL > 70 mg/dl y la falla cardiaca (OR: 0,4 p= 0,0178 y OR 1,96 p=0,078, respectivamente).Conclusiones: La suma de la medición de las variables antropométricas y de composición corporal por DXA ofrece información valiosa para el estudio y estimación del riesgo cardiovascular y metabólico de los pacientes. Abstract Introduction: Obesity and adiposity are associated with increased cardiovascular risk. The body mass index (BMI) and waist circumference are the most anthropometric variables used to assess their magnitude. This study aims to establish the relationship between adiposity and cardiometabolic outcomes measured by Dual X-ray Absorptiometry (DXA) as well as the diagnostic performance of the latter against the measurement of the conventional anthropometric variables. Materials and methods: An observational cross-sectional study was conducted; anthropometric and body composition variables for 60 patients in cardiac rehabilitation program phase II were calculated. Results: There was a higher prevalence of obesity by BMI and adiposity in women than in men (p = 0.01 and 0.048). The ROC curve found that the performance is only 65% for waist circumference and 65.6% for BMI for the diagnosis of adiposity. Significant correlations between high percentage of fat mass and coronary heart disease (OR: 1.9 p = 0.042) were found; as well as for increased BMI with hypertension (OR: 3.0 p = 0.0334) and LDL> 70mg/dl (OR: 0.4 p = 0.0178); increased waist circumference with heart failure (OR: 0.58 p = 0.0382); low basal metabolic rate (BMR) with hypertension (OR: 1.70 p = 0.046) and finally the decreased fat free mass index (FFMI) with LDL>70mg/dl and heart failure (OR: 0.4 p = 0.0178 and OR: 1.96 p = 0.078 respectively). Conclusions: The addition of body composition variables by DXA and anthropometric variables, provides valuable information for the study and estimation of cardiovascular and metabolic risk. Key Words: Obesity; DEXA Scans; Coronary Disease; BodyComposition; Body Mass Index; Adiposity.

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Threshold body mass index and sex-specific waist circumference for increased risk of heart failure with preserved ejection fraction

European Journal of Preventive Cardiology ◽

10.1177/2047487319851298 ◽

2019 ◽

Vol 26 (15) ◽

pp. 1594-1602 ◽

Cited By ~ 7

Author(s):

Duncan J Campbell ◽

Fei Fei Gong ◽

Michael V Jelinek ◽

Julian M Castro ◽

Jennifer M Coller ◽

...

Keyword(s):

Heart Failure ◽

Body Mass Index ◽

Waist Circumference ◽

Ejection Fraction ◽

Body Mass ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Randomised Trial ◽

Preserved Ejection Fraction ◽

Increased Risk

Background Body mass index †Deceased. (BMI) is a risk factor for heart failure with preserved ejection fraction (HFpEF). Design We investigated the threshold BMI and sex-specific waist circumference associated with increased HFpEF incidence in the SCReening Evaluation of the Evolution of New Heart Failure (SCREEN-HF) study, a cohort study of a community-based population at increased cardiovascular disease risk. Methods Inclusion criteria were age ≥60 years with one or more of self-reported hypertension, diabetes, heart disease, abnormal heart rhythm, cerebrovascular disease or renal impairment. Exclusion criteria were known heart failure, ejection fraction <50% or more than mild valve abnormality. Among 3847 SCREEN-HF participants, 73 were diagnosed with HFpEF at a median of 4.5 (interquartile range: 2.9–5.5) years after enrolment. Results HFpEF incidence rates were higher for BMI ≥27.5 kg/m2 than for BMI < 25 kg/m2, and for waist circumference >100 cm (men) or > 90 cm (women) than for waist circumference ≤94 cm (men) or ≤ 83 cm (women) in Poisson regression analysis. Semiparametric proportional hazards analyses confirmed these BMI and waist circumference thresholds, and exceeding these thresholds was associated with an attributable risk of HFpEF of 44–49%. Conclusions Both central obesity and overweight were associated with increased HFpEF incidence. Although a randomised trial of weight control would be necessary to establish a causal relationship between obesity/overweight and HFpEF incidence, these data suggest that maintenance of BMI and waist circumference below these thresholds in a community similar to that of the SCREEN-HF cohort may reduce the HFpEF incidence rate by as much as 50%.

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Enlarged waist combined with elevated triglycerides (hypertriglyceridemic waist phenotype) and HDL-cholesterol in patients with heart failure

Sao Paulo Medical Journal ◽

10.1590/1516-3180.2016.004519102016 ◽

2017 ◽

Vol 135 (1) ◽

pp. 50-56 ◽

Cited By ~ 3

Author(s):

Camila Weschenfelder ◽

Aline Marcadenti ◽

Airton Tetelbom Stein ◽

Catarina Bertaso Andreatta Gottschall

Keyword(s):

Heart Failure ◽

Body Mass Index ◽

Waist Circumference ◽

Body Mass ◽

Hdl Cholesterol ◽

Hypertriglyceridemic Waist ◽

Significant Difference ◽

Patients With Heart Failure ◽

The Mean ◽

Hypertriglyceridemic Waist Phenotype

ABSTRACT CONTEXT AND OBJECTIVE: The association of serum triglycerides plus waist circumference seems to be a good marker of cardiovascular risk and has been named the “hypertriglyceridemic waist” phenotype. The aim of our study was to investigate the association between the hypertriglyceridemic waist phenotype and HDL-cholesterol among patients with heart failure. DESIGN AND SETTING: Cross-sectional study in a tertiary-level hospital in southern Brazil. METHODS: We included patients with heart failure aged > 40 years. Anthropometric assessment (weight, height, waist and hip circumferences) was performed; body mass index (BMI) and waist-hip ratio were calculated and lipid measurements (serum total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides) were collected. In men and women, respectively, waist circumference ≥ 94 cm and ≥ 80 cm, and triglycerides ≥ 150 mg/dl were considered abnormal and were used to identify the hypertriglyceridemic waist phenotype. Analyses of covariance were used to evaluate possible associations between levels of HDL-cholesterol and the hypertriglyceridemic waist phenotype, according to sex. RESULTS: 112 participants were included, of whom 62.5% were men. The mean age was 61.8 ± 12.3 years and the mean ejection fraction was 40.1 ± 14.7%. Men and woman presented mean HDL-cholesterol of 40.5 ± 14.6 and 40.9 ± 12.7 mg/dl, respectively. The prevalence of the hypertriglyceridemic waist phenotype was 25%. There was a significant difference in mean HDL-cholesterol between men with and without the hypertriglyceridemic waist phenotype (32.8 ± 14.2 versus 42.1 ± 13.7 mg/dl respectively; P = 0.04), even after adjustment for age, body mass index, type 2 diabetes mellitus, use of statins and heart failure etiology. CONCLUSIONS: The hypertriglyceridemic waist phenotype is significantly associated with lower HDL-cholesterol levels in men with heart failure.

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