March 02, 2015
Circulation: Heart Failure
CIRCHEARTFAILURE.114.001837
Published online before print February 13, 2015, doi: 10.1161/CIRCHEARTFAILURE.114.001837
TAKE-HOME MESSAGE
- A large prospective cohort study of 31,155 patients examined the association between body mass index (BMI) and heart failure risk among those with type 2 diabetes. A significant increased risk for heart failure was associated with increasing BMI levels for both men and women, even when the data were stratified by race, smoking status, age, and use of antidiabetic drugs.
- Among those with type 2 diabetes, the results indicate a positive association and a J-shaped association between BMI and heart failure risk among men and women, respectively.
Abstract
BACKGROUND
Epidemiologic data on the association between body mass index (BMI) and heart failure (HF) risk among diabetic patients are rare.
METHODS AND RESULTS
We performed a prospective cohort study of risk for HF among 31,155 patients with type 2 diabetes (11,468 men and 19,687 women). Cox proportional hazards regression models were used to estimate the association of different levels of BMI with HF risk. During a mean follow-up of 7.8 years, 5,834 subjects developed HF (2,379 men and 3,455 women). The multivariable-adjusted (age, race, smoking, income and type of insurance) hazard ratios of HF associated with BMI levels (18.5-22.9, 23-24.9, 25-29.9 [reference group], 30-34.9, 35-39.9, and ≥40 kg/m2) at baseline were 0.95, 1.00, 1.00, 1.16, 1.64, and 2.02 (Ptrend <0.001) for men, and 1.16, 1.16, 1.00, 1.23, 1.55, and 2.01 (Pnon-linear <0.001) for women, respectively. When we used an updated mean value of BMI, the association of HF risk with BMI did not change. When stratified by age, race, smoking status and use of anti-diabetic drugs, the positive associations among men and the J-shaped associations among women were still present.
CONCLUSIONS
Our study suggests a positive association between BMI and HF risk among men, and a J-shaped association between BMI and HF risk among women with type 2 diabetes.