ArticleEuropean journal of heart failure2011
Absence of obesity paradox in patients with chronic heart failure and diabetes mellitus: a propensity-matched study.
Article in European journal of heart failure, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers.
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48 citing papers in PubMed, 102 citations in OpenAlex.
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- Reduced thoracic skeletal muscle size is associated with adverse outcomes in diabetes patients with heart failure and reduced ejection fraction: quantitative analysis of sarcopenia by using cardiac MRI.Cardiovascular diabetology · 2024Article
- Association between knee osteoarthritis and mortality: a serial propensity score-matched cohort study.The Korean journal of internal medicine · 2023Article
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- Body Mass Index, Muscle Mass, and All-Cause Mortality in Patients With Acute Heart Failure: The Obesity Paradox Revisited.International journal of heart failure · 2022Article
- Association between body mass index and survival in Taiwanese heart failure patients with and without diabetes mellitus.Medicine · 2021Article
- The obesity paradox and diabetes.Eating and weight disorders : EWD · 2021Review
- Nutrition as Treatment Modality in Heart Failure.Current atherosclerosis reports · 2021Review
- The "Obesity Paradox" in Patients With HFpEF With or Without Comorbid Atrial Fibrillation.Frontiers in cardiovascular medicine · 2021Article
- Collider bias undermines our understanding of COVID-19 disease risk and severity.Nature communications · 2020Article
- Body mass index and cardiovascular outcomes in patients with acute coronary syndrome by diabetes status: the obesity paradox in a Korean national cohort study.Cardiovascular diabetology · 2020Article
- Association between body mass index and prognosis of patients hospitalized with heart failure.Scientific reports · 2020Article
- Weight loss in heart failure is associated with increased mortality only in non-obese patients without diabetes.Journal of cachexia, sarcopenia and muscle · 2019Article
- Bridging the Gap Between Diabetes and Stroke in Search of High Clinical Relevance Therapeutic Targets.Neuromolecular medicine · 2019Review
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11 authors at 7 institutions in 6 countries.
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Abstract
aimsObesity is paradoxically associated with survival benefit in patients with chronic heart failure (HF). However, obesity complicates the management of diabetes mellitus (DM), which is common in HF. Yet, little is known about the impact of obesity in HF patients with DM. Therefore, we examined the association between obesity and outcomes in propensity-matched cohorts of HF patient with and without DM. METHODS AND
resultsOf the 7788 participants with chronic mild to moderate HF in the Digitalis Investigation Group trial, 7379 were non-cachectic [body mass index (BMI) ≥ 20 kg/m²] at baseline. Of these, 2153 (29%) had DM, of whom 798 (37%) were obese (BMI ≥ 30 kg/m²). Of the 5226 patients without DM, 1162 (22%) were obese. Propensity scores for obesity were used to separately assemble 636 pairs of obese and non-obese patients with DM and 770 pairs of obese and non-obese patients without DM, who were balanced on 32 baseline characteristics. Among matched patients with DM, all-cause mortality occurred in 38 and 39% of obese and non-obese patients, respectively [hazard ratio (HR) when obesity was compared with no obesity 0.99; 95% confidence interval (CI) 0.80-1.22; P = 0.915]. Among matched patients without DM, all-cause mortality occurred in 23 and 27% obese and non-obese patients, respectively (HR associated with obesity 0.77; 95% CI 0.61-0.97; P = 0.025).
conclusionIn patients with chronic mild to moderate HF and DM, obesity confers no paradoxical survival benefit. Whether intentional weight loss may improve outcomes in these patients needs to be investigated in future prospective studies.
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