The Obesity-Mortality Paradox in Patients With Heart Failure in Taiwan and a Collaborative Meta-Analysis for East Asian Patients

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• 作者：Gen-Min Lin ; MD^a ; ^b ; ^c ; Yi-Hwei Li ; PhD^c ; Wei-Hsian Yin ; MD^d ; Yen-Wen Wu ; MD^e ; Pao-Hsien Chu ; MD^f ; Chih-Cheng Wu ; MD^g ; Chih-Hsin Hsu ; MD^h ; Ming-Shien Wen ; MD^f ; Wen-Chol Voon ; MDⁱ ; Chun-Chieh Wang ; MD^f ; San-Jou Yeh ; MD^f ; Wei-Shiang Lin ; MD^a ; ^{wslin545@ms27.hinet.net" class="auth_mail" title="E-mail the corresponding author} ; on behalf of the Taiwan Society of Cardiology (TSOC) Heart Failure with Reduced Ejection Fraction (HFrEF) registry investigators ; committeeKuei-Chuan Chan ; Heng-Chia Chang ; Kuan-Cheng Chang ; Zhih-Cherng Chen ; Shyh-Ming Chen ; Pao-Hsien Chu ; Chih-Hsin Hsu ; Jin-Long Huang ; Jen yuan Kuo ; Jiunn-Lee Lin ; Wei-Shiang Lin ; Guang-Yuan Mar ; Kou-Gi Shyu ; Shih-Hsien Sung ; Wei-Kung Tseng ; Wen-Chol Voon ; Ji-Hung Wang ; Ming-Shien Wen ; Chih-Cheng Wu ; Yen-Wen Wu ; Ning-I. Yang ; Wei-Hsian Yin
• 刊名：The American Journal of Cardiology
• 出版年：2016
• 出版时间：1 October 2016
• 年：2016
• 卷：118
• 期：7
• 页码：1011-1018
• 全文大小：483 K

文摘

A global heart failure (HF) registry suggested that the inverse association between body mass index (BMI) and all-cause mortality differed by race, particularly stronger in Japanese patients at 1-year follow-up. Whether this finding was consistent across all East Asian populations was unknown. In a multicenter prospective study in Taiwan, we enrolled 1,301 patients hospitalized for systolic HF from 2013 to 2014 and followed up the mortality after their discharge for a median of 1-year period. Cox proportional hazard regression analyses were used to assess the association of BMI with all-cause mortality. The results showed that BMI was inversely associated with all-cause mortality (hazard ratio and 95% CI per 5-kg/m² increase: 0.75 [0.62 to 0.91]) after adjusting for demographics, traditional risk factors, HF severity, and medications at discharge. Subsequently, we sought previous studies regarding the BMI association with mortality for East Asian patients with HF from Medline, and a random-effect meta-analysis was performed by the inverse variance method. The meta-analysis including 7 previous eligible studies (3 for the Chinese and 4 for the Japanese cohorts) and the present one showed similar results that BMI was inversely associated with all-cause mortality (hazard ratio 0.65 [0.58 to 0.73], I² = 37%). In conclusion, our study in Taiwan and a collaborative meta-analysis confirmed a strong inverse BMI-mortality association consistently among East Asian patients with HF.