Weiqin Li1, Peter T Katzmarzyk1, Ronald Horswell1, Yonggang Zhang1, Yujie Wang1, Jolene Johnson1, Gang Hu2. 1. From the Pennington Biomedical Research Center, Baton Rouge, LA (W.L., P.T.K., R.H., Y.Z., Y.W., G.H.); Tianjin Women's and Children's Health Center, Tianjin, China (W.L.); and LSU Health Baton Rouge, LA (J.J.). 2. From the Pennington Biomedical Research Center, Baton Rouge, LA (W.L., P.T.K., R.H., Y.Z., Y.W., G.H.); Tianjin Women's and Children's Health Center, Tianjin, China (W.L.); and LSU Health Baton Rouge, LA (J.J.). gang.hu@pbrc.edu.
Abstract
BACKGROUND: Epidemiological 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 mellitus (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, 5834 subjects developed HF (2379 men and 3455 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/m(2)) 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 (Pnonlinear<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 antidiabetic 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 mellitus.
BACKGROUND: Epidemiological data on the association between body mass index (BMI) and heart failure (HF) risk among diabeticpatients are rare. METHODS AND RESULTS: We performed a prospective cohort study of risk for HF among 31 155 patients with type 2 diabetes mellitus (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, 5834 subjects developed HF (2379 men and 3455 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/m(2)) 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 (Pnonlinear<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 antidiabetic 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 mellitus.
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