BMI is inversely correlated to the risk of mortality in patients with type 2 diabetes hospitalized for acute heart failure: Findings from the Gulf aCute heArt failuRE (Gulf-CARE) registry

Charbel Abi Khalil, Kadhim Sulaiman, Rajvir Singh, Amin Jayyousi, Nidal Asaad, Khalid F. AlHabib, Alawi Alsheikh-Ali, Mohammed Al-Jarallah, Bassam Bulbanat, Wael AlMahmeed, Soha Dargham, Mustafa Ridha, Nooshin Bazargani, Haitham Amin, Ahmed Al-Motarreb, Husam AlFaleh, Abdelfatah Elasfar, Prashanth Panduranga, Jassim Al Suwaidi

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Abstract

Background: A U-shaped relationship has been reported between BMI and cardiovascular events among patients with acute heart failure (AHF). We hypothesized that an obesity paradox also governs the relationship between BMI and mortality in patients with type 2 diabetes (T2D) and AHF. Methods: We studied 3-month and 12-month mortality in patients with T2D hospitalized for AHF according to 5 BMI categories: Underweight (<20kg/m2), normal weight (referent group, 20-24.9kg/m2), overweight, (25-29.9kg/m2), obese (30-34.9kg/m2) and severely obese (≥35kg/m2), in the Gulf aCute heArt failuRe rEgistry (GULF-CARE). Results: Among the 5005 participants in this cohort, 2492 (49.8%) had T2D. Underweight patients had a higher 3-month and 12-month mortality risk (OR 2.04, 95% CI [1.02-4.08]; OR 2.44, 95% CI [1.35-4.3]; respectively), compared to normal weight. Severe obesity was associated with a lower 3-month and 12-month mortality risk (OR 0.53, 95% CI [0.34-0.83]; OR 0.58, 95% CI [0.42-0.81]; respectively). After adjustment for several risk variables in 2 different models, the primary outcome was still significantly increased in underweight patients, and decreased in severely obese patients, at 3. months and 12. months. Further, the odds of mortality decreases with increasing BMI by 0.38 at 3. months and at 0.45 at 12. months in a near-linear shape (p = 0.007; p = 0.037; respectively). Conclusions: In this cohort of patients with AHF, BMI was inversely correlated to the risk of mortality in patients with T2D. Moreover, severe obesity was associated with less mortality risk.

Original languageEnglish
JournalInternational Journal of Cardiology
DOIs
Publication statusAccepted/In press - 10 Dec 2016
Externally publishedYes

Fingerprint

Type 2 Diabetes Mellitus
Registries
Heart Failure
Mortality
Thinness
Morbid Obesity
Risk Adjustment
Weights and Measures
Obesity

Keywords

  • BMI
  • Cardiovascular mortality
  • Diabetes
  • Heart failure

ASJC Scopus subject areas

  • Medicine(all)
  • Cardiology and Cardiovascular Medicine

Cite this

BMI is inversely correlated to the risk of mortality in patients with type 2 diabetes hospitalized for acute heart failure : Findings from the Gulf aCute heArt failuRE (Gulf-CARE) registry. / Abi Khalil, Charbel; Sulaiman, Kadhim; Singh, Rajvir; Jayyousi, Amin; Asaad, Nidal; AlHabib, Khalid F.; Alsheikh-Ali, Alawi; Al-Jarallah, Mohammed; Bulbanat, Bassam; AlMahmeed, Wael; Dargham, Soha; Ridha, Mustafa; Bazargani, Nooshin; Amin, Haitham; Al-Motarreb, Ahmed; AlFaleh, Husam; Elasfar, Abdelfatah; Panduranga, Prashanth; Al Suwaidi, Jassim.

In: International Journal of Cardiology, 10.12.2016.

Research output: Contribution to journalArticle

Abi Khalil, C, Sulaiman, K, Singh, R, Jayyousi, A, Asaad, N, AlHabib, KF, Alsheikh-Ali, A, Al-Jarallah, M, Bulbanat, B, AlMahmeed, W, Dargham, S, Ridha, M, Bazargani, N, Amin, H, Al-Motarreb, A, AlFaleh, H, Elasfar, A, Panduranga, P & Al Suwaidi, J 2016, 'BMI is inversely correlated to the risk of mortality in patients with type 2 diabetes hospitalized for acute heart failure: Findings from the Gulf aCute heArt failuRE (Gulf-CARE) registry', International Journal of Cardiology. https://doi.org/10.1016/j.ijcard.2017.02.119
Abi Khalil, Charbel ; Sulaiman, Kadhim ; Singh, Rajvir ; Jayyousi, Amin ; Asaad, Nidal ; AlHabib, Khalid F. ; Alsheikh-Ali, Alawi ; Al-Jarallah, Mohammed ; Bulbanat, Bassam ; AlMahmeed, Wael ; Dargham, Soha ; Ridha, Mustafa ; Bazargani, Nooshin ; Amin, Haitham ; Al-Motarreb, Ahmed ; AlFaleh, Husam ; Elasfar, Abdelfatah ; Panduranga, Prashanth ; Al Suwaidi, Jassim. / BMI is inversely correlated to the risk of mortality in patients with type 2 diabetes hospitalized for acute heart failure : Findings from the Gulf aCute heArt failuRE (Gulf-CARE) registry. In: International Journal of Cardiology. 2016.
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title = "BMI is inversely correlated to the risk of mortality in patients with type 2 diabetes hospitalized for acute heart failure: Findings from the Gulf aCute heArt failuRE (Gulf-CARE) registry",
abstract = "Background: A U-shaped relationship has been reported between BMI and cardiovascular events among patients with acute heart failure (AHF). We hypothesized that an obesity paradox also governs the relationship between BMI and mortality in patients with type 2 diabetes (T2D) and AHF. Methods: We studied 3-month and 12-month mortality in patients with T2D hospitalized for AHF according to 5 BMI categories: Underweight (<20kg/m2), normal weight (referent group, 20-24.9kg/m2), overweight, (25-29.9kg/m2), obese (30-34.9kg/m2) and severely obese (≥35kg/m2), in the Gulf aCute heArt failuRe rEgistry (GULF-CARE). Results: Among the 5005 participants in this cohort, 2492 (49.8{\%}) had T2D. Underweight patients had a higher 3-month and 12-month mortality risk (OR 2.04, 95{\%} CI [1.02-4.08]; OR 2.44, 95{\%} CI [1.35-4.3]; respectively), compared to normal weight. Severe obesity was associated with a lower 3-month and 12-month mortality risk (OR 0.53, 95{\%} CI [0.34-0.83]; OR 0.58, 95{\%} CI [0.42-0.81]; respectively). After adjustment for several risk variables in 2 different models, the primary outcome was still significantly increased in underweight patients, and decreased in severely obese patients, at 3. months and 12. months. Further, the odds of mortality decreases with increasing BMI by 0.38 at 3. months and at 0.45 at 12. months in a near-linear shape (p = 0.007; p = 0.037; respectively). Conclusions: In this cohort of patients with AHF, BMI was inversely correlated to the risk of mortality in patients with T2D. Moreover, severe obesity was associated with less mortality risk.",
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TY - JOUR

T1 - BMI is inversely correlated to the risk of mortality in patients with type 2 diabetes hospitalized for acute heart failure

T2 - Findings from the Gulf aCute heArt failuRE (Gulf-CARE) registry

AU - Abi Khalil, Charbel

AU - Sulaiman, Kadhim

AU - Singh, Rajvir

AU - Jayyousi, Amin

AU - Asaad, Nidal

AU - AlHabib, Khalid F.

AU - Alsheikh-Ali, Alawi

AU - Al-Jarallah, Mohammed

AU - Bulbanat, Bassam

AU - AlMahmeed, Wael

AU - Dargham, Soha

AU - Ridha, Mustafa

AU - Bazargani, Nooshin

AU - Amin, Haitham

AU - Al-Motarreb, Ahmed

AU - AlFaleh, Husam

AU - Elasfar, Abdelfatah

AU - Panduranga, Prashanth

AU - Al Suwaidi, Jassim

PY - 2016/12/10

Y1 - 2016/12/10

N2 - Background: A U-shaped relationship has been reported between BMI and cardiovascular events among patients with acute heart failure (AHF). We hypothesized that an obesity paradox also governs the relationship between BMI and mortality in patients with type 2 diabetes (T2D) and AHF. Methods: We studied 3-month and 12-month mortality in patients with T2D hospitalized for AHF according to 5 BMI categories: Underweight (<20kg/m2), normal weight (referent group, 20-24.9kg/m2), overweight, (25-29.9kg/m2), obese (30-34.9kg/m2) and severely obese (≥35kg/m2), in the Gulf aCute heArt failuRe rEgistry (GULF-CARE). Results: Among the 5005 participants in this cohort, 2492 (49.8%) had T2D. Underweight patients had a higher 3-month and 12-month mortality risk (OR 2.04, 95% CI [1.02-4.08]; OR 2.44, 95% CI [1.35-4.3]; respectively), compared to normal weight. Severe obesity was associated with a lower 3-month and 12-month mortality risk (OR 0.53, 95% CI [0.34-0.83]; OR 0.58, 95% CI [0.42-0.81]; respectively). After adjustment for several risk variables in 2 different models, the primary outcome was still significantly increased in underweight patients, and decreased in severely obese patients, at 3. months and 12. months. Further, the odds of mortality decreases with increasing BMI by 0.38 at 3. months and at 0.45 at 12. months in a near-linear shape (p = 0.007; p = 0.037; respectively). Conclusions: In this cohort of patients with AHF, BMI was inversely correlated to the risk of mortality in patients with T2D. Moreover, severe obesity was associated with less mortality risk.

AB - Background: A U-shaped relationship has been reported between BMI and cardiovascular events among patients with acute heart failure (AHF). We hypothesized that an obesity paradox also governs the relationship between BMI and mortality in patients with type 2 diabetes (T2D) and AHF. Methods: We studied 3-month and 12-month mortality in patients with T2D hospitalized for AHF according to 5 BMI categories: Underweight (<20kg/m2), normal weight (referent group, 20-24.9kg/m2), overweight, (25-29.9kg/m2), obese (30-34.9kg/m2) and severely obese (≥35kg/m2), in the Gulf aCute heArt failuRe rEgistry (GULF-CARE). Results: Among the 5005 participants in this cohort, 2492 (49.8%) had T2D. Underweight patients had a higher 3-month and 12-month mortality risk (OR 2.04, 95% CI [1.02-4.08]; OR 2.44, 95% CI [1.35-4.3]; respectively), compared to normal weight. Severe obesity was associated with a lower 3-month and 12-month mortality risk (OR 0.53, 95% CI [0.34-0.83]; OR 0.58, 95% CI [0.42-0.81]; respectively). After adjustment for several risk variables in 2 different models, the primary outcome was still significantly increased in underweight patients, and decreased in severely obese patients, at 3. months and 12. months. Further, the odds of mortality decreases with increasing BMI by 0.38 at 3. months and at 0.45 at 12. months in a near-linear shape (p = 0.007; p = 0.037; respectively). Conclusions: In this cohort of patients with AHF, BMI was inversely correlated to the risk of mortality in patients with T2D. Moreover, severe obesity was associated with less mortality risk.

KW - BMI

KW - Cardiovascular mortality

KW - Diabetes

KW - Heart failure

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