Takeaway
- Higher waist-hip ratio (WHR) is associated with increased risk for mortality in female but not in male patients with heart failure (HF).
- This association may be explained by higher inflammatory status and is independent of BMI.
Why this matters
- Abdominal fat is better estimated by measuring WHR however; association between WHR and clinical outcome in patients with established HF is unknown.
- Findings challenge the obesity paradox and suggest the pathophysiological harmful effect of abdominal fat deposition, which may be a target for therapy in patients with HF.
Method:
- Retrospective study of 1479 patients (men, n=997; women, n=482) with high BMI from the Scottish BIOlogy Study to TAilored Treatment in Chronic Heart Failure (BIOSTAT-CHF) validation study.
- Funding: The Netherlands Cardiovascular Research Initiative.
Study results
- Mean WHR was 0.93±0.09 in women and 1.00±0.08 in men.
- In both women and men, a higher WHR was associated with higher body weight (P=.003 and P<.001), higher glucose levels (P=.004 and P=.001) and lower serum iron levels (P=.021 and P=.020).
- Significant interaction was seen between sex and WHR on the risk of death (Pinteraction<.001).
- In women with high WHR, risk for mortality was significantly high (HR, 2.23; 95% CI, 1.37-3.63; P=.001) vs men with high WHR (HR, 0.87; 95% 0.63-1.20; P=.409).
Limitation:
- Retrospective design.
- Difficult to differentiate between fat and fluid in patients with HF and a large abdominal mass.
References
References