Hassanin Ahmed, Hassanein Mahmoud, Lanier Gregg M, Sadaka Mohamed, Rifaat Mohamed, Sanhoury Mohamed
Westchester Medical Center/New York Medical College, Valhalla, USA.
Alexandria University, Alexandria, Egypt.
Egypt Heart J. 2022 Jan 3;74(1):1. doi: 10.1186/s43044-021-00232-y.
Obesity is an established risk factor for cardiometabolic disease and heart failure (HF). Nevertheless, the relationship between obesity and HF mortality remains controversial.
The goal of this study was to describe the prevalence of obesity in patients hospitalized for HF in Egypt and investigate the relationship of obesity to cardiometabolic risk factors, HF phenotype and mortality. Between 2011 and 2014, 1661 patients hospitalized for HF across Egypt were enrolled as part of the European Society of Cardiology HF Long-term Registry. Obese patients, defined by a BMI ≥ 30 kg/m, were compared to non-obese patients. Factors associated with mortality on univariate analysis were entered into a logistic regression model to identify whether obesity was an independent predictor of mortality during hospitalization and at one-year follow-up. The prevalence of obesity was 46.5% and was higher in females compared to males. Obese as compared to non-obese patients had a higher prevalence of diabetes mellitus (47.0% vs 40.2%, p = 0.031), hypertension (51.3% vs 33.0%, p < 0.001) and history of myocardial infarction (69.2% vs 62.8% p = 0.005). Obese patients as compared to non-obese patient were more likely to have acute coronary syndrome on admission (24.8% vs 14.2%, p < < 0.001). The dominant HF phenotype in obese and non-obese patients was HF with reduced ejection fraction (EF); however, obese patients as compared to non-obese patient had higher prevalence of HF with preserved EF (22.3% vs 12.4%, p < 0.001). Multivariable analysis demonstrated that obesity was associated with an independent survival benefit during hospitalization, (OR for mortality 0.52 [95% CI 0.29-0.92]). Every point increase in BMI was associated with an OR = 0.93 [95% CI 0.89-0.98] for mortality during hospitalization. The survival benefit was not maintained at one-year follow-up.
Obesity was highly prevalent among the study cohort and was associated with higher prevalence of cardiometabolic risk factors as compared to non-obese patients. Obesity was associated with an independent "protective effect" from in-hospital mortality but was not a predictor of mortality at 1-year follow-up.
肥胖是已确定的心血管代谢疾病和心力衰竭（HF）的危险因素。然而，肥胖与HF死亡率之间的关系仍存在争议。
本研究的目的是描述埃及因HF住院患者的肥胖患病率，并调查肥胖与心血管代谢危险因素、HF表型和死亡率之间的关系。2011年至2014年期间，埃及1661名因HF住院的患者作为欧洲心脏病学会HF长期注册研究的一部分被纳入研究。将体重指数（BMI）≥30kg/m²定义的肥胖患者与非肥胖患者进行比较。单因素分析中与死亡率相关的因素被纳入逻辑回归模型，以确定肥胖是否是住院期间和一年随访时死亡率的独立预测因素。肥胖患病率为46.5%，女性高于男性。与非肥胖患者相比，肥胖患者糖尿病患病率更高（47.0%对40.2%，p = 0.031）、高血压患病率更高（51.3%对33.0%，p < 0.001）以及心肌梗死病史患病率更高（69.2%对62.8%，p = 0.005）。与非肥胖患者相比，肥胖患者入院时更可能患有急性冠状动脉综合征（24.8%对14.2%，p < < 0.001）。肥胖和非肥胖患者中主要的HF表型是射血分数降低（EF）的HF；然而，与非肥胖患者相比，肥胖患者射血分数保留的HF患病率更高（22.3%对12.4%，p < 0.001）。多变量分析表明，肥胖与住院期间的独立生存获益相关（死亡率的比值比为0.52 [95%可信区间0.29 - 0.92]）。BMI每增加1个单位，住院期间死亡率的比值比为0.93 [95%可信区间0.89 - 0.98]。在一年随访时生存获益未维持。
肥胖在研究队列中非常普遍，与非肥胖患者相比，肥胖与心血管代谢危险因素的患病率更高相关。肥胖与住院死亡率的独立“保护作用”相关，但不是一年随访时死亡率的预测因素。
