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肥胖与男性和女性患者心力衰竭症状之间的关联。

Association between obesity and heart failure symptoms in male and female patients.

作者信息

Heo S, Moser D K, Pressler S J, Dunbar S B, Lee K S, Kim J, Lennie T A

机构信息

College of Nursing, University of Arkansas for Medical Sciences, Little Rock, AR, USA.

College of Nursing, University of Kentucky, Lexington, KY, USA.

出版信息

Clin Obes. 2017 Apr;7(2):77-85. doi: 10.1111/cob.12179. Epub 2017 Jan 24.

Abstract

In patients with heart failure (HF), higher body mass index (BMI) has been associated with lower rates of hospitalization and mortality (obesity paradox). Symptoms are antecedents of hospitalizations, but little is known about the relationship between BMI and symptoms and gender differences. To examine the association of BMI with symptoms in male and female patients with HF, controlling for covariates (sample characteristics, depressive symptoms and sodium intake). In this cross-sectional correlational study, patients (N = 247) provided data on BMI, symptoms and covariates. BMI was categorized into four groups: normal/underweight (<25 kg/m ), overweight (25-29.9 kg/m ), obese I (30-34.9 kg/m ) and obese II/III (≥35 kg/m ). General linear regression was used to analyse the data. The Obese II/III group had more severe HF symptoms than other groups only in male patients. In male patients, older age, Caucasian race, more comorbidities and more severe depressive symptoms were also associated with more severe symptoms. In female patients, more severe depressive symptoms, more comorbidities and higher sodium intake were associated with more severe symptoms. The obesity paradox does not fully extend to symptoms, and gender has a role in the relationship between obesity and symptoms.

摘要

在心力衰竭(HF)患者中,较高的体重指数(BMI)与较低的住院率和死亡率相关(肥胖悖论)。症状是住院的先兆,但关于BMI与症状之间的关系以及性别差异知之甚少。为了研究BMI与男性和女性HF患者症状之间的关联,并控制协变量(样本特征、抑郁症状和钠摄入量)。在这项横断面相关性研究中,患者(N = 247)提供了关于BMI、症状和协变量的数据。BMI被分为四组:正常/体重过轻(<25 kg/m²)、超重(25 - 29.9 kg/m²)、肥胖I级(30 - 34.9 kg/m²)和肥胖II/III级(≥35 kg/m²)。采用一般线性回归分析数据。仅在男性患者中,肥胖II/III级组的HF症状比其他组更严重。在男性患者中,年龄较大、白种人、更多的合并症和更严重的抑郁症状也与更严重的症状相关。在女性患者中,更严重的抑郁症状、更多的合并症和更高的钠摄入量与更严重的症状相关。肥胖悖论并未完全适用于症状,并且性别在肥胖与症状之间的关系中起作用。

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Reply: Concerning the Role of Gender Difference in Obesity Paradox in Patients With Heart Failure.
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Concerning the Role of Gender Difference in Obesity Paradox in Patients With Heart Failure.
JACC Heart Fail. 2016 Mar;4(3):235-6. doi: 10.1016/j.jchf.2015.11.012.
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Update on Obesity and Obesity Paradox in Heart Failure.心力衰竭中肥胖及肥胖悖论的最新进展
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