腹型肥胖与射血分数保留的心力衰竭患者肾功能恶化风险增加相关。

Abdominal obesity is associated with increased worsening renal function risk in patients with heart failure with preserved ejection fraction.

机构信息

Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China.

出版信息

BMC Cardiovasc Disord. 2024 Sep 9;24(1):477. doi: 10.1186/s12872-024-04118-0.

DOI:10.1186/s12872-024-04118-0

PMID:39251903

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11382427/

Abstract

BACKGROUND

Worsening renal function (WRF) is a frequent comorbidity of heart failure with preserved ejection fraction (HFpEF). However, its relationship with abdominal obesity in terms of HFpEF remains unclear. This study aimed to evaluate the value of waist circumference (WC) and body mass index (BMI) in predicting WRF and examine the correlation between abdominal obesity and the risk of WRF in the HFpEF population.

METHODS

Data were obtained from the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist trial. Abdominal obesity was defined as WC ≥ 102 cm for men and ≥ 88 cm for women. WRF was defined as doubling of serum creatinine concentration from baseline. Restricted cubic splines and receiver operating characteristic curves were used to evaluate the value of WC and BMI in predicting WRF. Cumulative incidence curves and cox proportional-hazards models were used to compare patients with and without abdominal obesity.

RESULTS

We included 2,806 patients with HFpEF in our study (abdominal obesity, n: 2,065). Although baseline creatinine concentrations did not differ, patients with abdominal obesity had higher concentrations during a median follow-up time of 40.9 months. Unlike BMI, WC exhibited a steady linear association with WRF and was a superior WRF predictor. Patients with abdominal obesity exhibited a higher risk of WRF after multivariable adjustment (hazard ratio: 1.632; 95% confidence interval: 1.015-2.621; P: 0.043).

CONCLUSIONS

Abdominal obesity is associated with an increased risk of WRF in the HFpEF population.

TRIAL REGISTRATION

URL: https://beta.

CLINICALTRIALS

gov . Unique identifier: NCT00094302.

摘要

背景

肾功能恶化（WRF）是射血分数保留型心力衰竭（HFpEF）的常见合并症。然而，它与腹型肥胖在 HFpEF 中的关系尚不清楚。本研究旨在评估腰围（WC）和体重指数（BMI）在预测 WRF 中的价值，并研究腹型肥胖与 HFpEF 人群中 WRF 风险之间的相关性。

方法

数据来自醛固酮拮抗剂治疗保留心功能心力衰竭试验。腹型肥胖定义为男性 WC≥102cm，女性 WC≥88cm。WRF 定义为血清肌酐浓度从基线值增加两倍。受限立方样条和受试者工作特征曲线用于评估 WC 和 BMI 预测 WRF 的价值。累积发生率曲线和 Cox 比例风险模型用于比较有和无腹型肥胖的患者。

结果

我们纳入了 2806 例 HFpEF 患者（腹型肥胖，n：2065）。尽管基线肌酐浓度没有差异，但腹型肥胖患者在中位随访时间 40.9 个月期间的浓度更高。与 BMI 不同，WC 与 WRF 呈稳定的线性关系，是更好的 WRF 预测指标。在多变量调整后，腹型肥胖患者的 WRF 风险更高（风险比：1.632；95%置信区间：1.015-2.621；P：0.043）。