Zaqout Mahmoud, Vandekerckhove Kristof, Michels Nathalie, Demulier Laurent, Bove Thierry, François Katrien, De Backer Julie, De Henauw Stefaan, De Wolf Daniel
Department of Pediatric Cardiology, Ghent University Hospital, Ghent, Belgium.
Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
Congenit Heart Dis. 2019 May;14(3):479-486. doi: 10.1111/chd.12751. Epub 2019 Jan 25.
To investigate the status of body mass index (BMI) in adult people with congenital heart disease (ACHD).
Five hundred thirty-nine adults with CHD (53.8% men) were seen in the outpatient clinic from 2013 to 2015 and compared to a reference population (n = 1737). The severity of CHD was categorized as mild, moderate, and severe according to standard guidelines. Patients were categorized based on BMI as underweight (<18.5), overweight (25-30), or obese (>30). Echocardiography and magnetic resonance imaging were used to measure ventricular function while exercise capacity was estimated via cardiopulmonary exercise test.
Adults with CHD had slightly lower BMI than the reference group (24.1 ± 4.3 vs 24.6 ± 4.3; P = .012). Men in the mild and severe group (23.9 ± 3.6; 23.3 ± 4.4 vs 25.1 ± 3.7; P = .007; P = .023) and women in the severe group (21.6 ± 3.3 vs 24.2 ± 4.7; P < .001) had lower BMI compared to the reference group. In the subgroups, men with ventricular septal defect, coarctation of aorta/ventricular septal defect and Fontan circulation and women with Fontan circulation had lower BMI than the reference group. Underweight was more prevalent in women with severe lesions compared to the reference group (22.2% vs 3.8%; P < .001). BMI was associated with age and exercise capacity in patients with mild and moderate lesions, while higher BMI was related to better ventricular function in women with Fontan circulation.
Underweight was more prevalent in ACHD patients with severe lesions. Special attention should be paid to the possible existence of underweight-related comorbidities.
调查成年先天性心脏病患者（ACHD）的体重指数（BMI）状况。
2013年至2015年期间，539例成年CHD患者（男性占53.8%）在门诊接受检查，并与一个参考人群（n = 1737）进行比较。根据标准指南，CHD的严重程度分为轻度、中度和重度。患者根据BMI分为体重过轻（<18.5）、超重（25 - 30）或肥胖（>30）。采用超声心动图和磁共振成像测量心室功能，同时通过心肺运动试验评估运动能力。
CHD成年患者的BMI略低于参考组（24.1±4.3 vs 24.6±4.3；P = 0.012）。轻度和重度组的男性（23.9±3.6；23.3±4.4 vs 25.1±3.7；P = 0.007；P = 0.023）以及重度组的女性（21.6±3.3 vs 24.2±4.7；P < 0.001）的BMI低于参考组。在亚组中，患有室间隔缺损、主动脉缩窄/室间隔缺损和Fontan循环的男性以及患有Fontan循环的女性的BMI低于参考组。与参考组相比，患有严重病变的女性体重过轻更为普遍（22.2% vs 3.8%；P < 0.001）。BMI与轻度和中度病变患者的年龄和运动能力相关，而较高的BMI与Fontan循环女性更好的心室功能相关。
严重病变的ACHD患者体重过轻更为普遍。应特别关注体重过轻相关合并症的可能存在。
