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首页> 外文期刊>The American Journal of Cardiology >The obesity paradox in men versus women with systolic heart failure
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The obesity paradox in men versus women with systolic heart failure

机译：患有收缩性心力衰竭的男性和女性的肥胖悖论

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Obesity is common in heart failure (HF) and is associated with improved outcomes, a finding often termed the "obesity paradox." Although fat distribution varies by gender, the role of obesity in the outcomes of women compared to men with HF has not been well studied. In a cohort of patients with advanced systolic HF followed at a single university center, 2,718 patients had body mass indexes (BMIs) measured at baseline, and 469 patients with HF had waist circumferences (WCs) measured at baseline. Elevated BMI was defined as 25 kg/m 2. High WC was defined as 88 cm in women and 102 cm in men. The primary outcome was death, urgent heart transplantation, or ventricular assist device placement. The mean age was 53.0 ± 12.4 years, 25% of subjects were women, and the mean left ventricular ejection fraction was 22.9 ± 7.19%. In men, 2-year event-free survival was better for high versus normal BMI (63.2% vs 53.5%, p 0.001) and for high versus normal WC (78.8% vs 63.1%, p = 0.01). In women, 2-year event-free survival was better for elevated versus normal BMI (67.1% vs 56.6%, p = 0.01) but similar in the 2 WC groups. In multivariate analyses, normal BMI and normal WC were associated with higher relative risk for the primary outcome in men (BMI 1.34, WC 2.02) and women (BMI 1.38, WC 2.99). In conclusion, in patients with advanced HF, high BMI and WC were associated with improved outcomes in both genders. Further investigation of the interaction between body composition and gender in HF outcomes is warranted.
机译：肥胖在心力衰竭（HF）中很常见，并且与转归改善有关，这一发现通常被称为“肥胖悖论”。尽管脂肪的分布因性别而异，但与男性心力衰竭相比，肥胖在女性结局中的作用尚未得到很好的研究。在一个大学中心随访的一组晚期收缩期HF患者中，有2,718例基线时测量了体重指数（BMI），而469名基线时测量了腰围（WC）。体重指数升高定义为<25 kg / m2。女性的高WC定义为<88 cm，男性<102 cm。主要结果是死亡，紧急心脏移植或放置心室辅助设备。平均年龄为53.0±12.4岁，其中25％为女性，平均左心室射血分数为22.9±7.19％。在男性中，高BMI与正常BMI（63.2％vs 53.5％，p <0.001）和高与正常WC（78.8％vs 63.1％，p = 0.01）的2年无事件生存期更好。在女性中，BMI升高与正常BMI相比，2年无事件生存率更好（67.1％vs 56.6％，p = 0.01），但在2个WC组中相似。在多变量分析中，男性（BMI 1.34，WC 2.02）和女性（BMI 1.38，WC 2.99）的正常BMI和WC与较高的主要结局相对风险相关。总之，在晚期HF患者中，高BMI和WC与两种性别的预后都有改善。有必要进一步研究HF结果中身体成分和性别之间的相互作用。

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