Diabetes status modifies the association between different measures of obesity and heart failure risk among older adults: A pooled analysis of community- based NHLBI cohorts

CirculationPatel KV, Segar MW, Lavie CJ, et al. | December 07, 2021


In older adults, higher body mass index (BMI), waist circumference (WC), and fat mass (FM) were identified to be strongly linked with greater risk of heart failure (HF), especially in those with prevalent diabetes.

  • Using participant-level data from ARIC(visit-5) and CHS(visit-1) cohorts, this study involved 10,387 participants (52.9% ARIC; 25.1% diabetes; median age: 74 years) to clarify inter-relationships between different measures of adiposity—overall obesity, central obesity, FM—and diabetes status for HF risk.

  • Higher levels of each adiposity measure were found to be significantly linked with higher HF risk (HR per 1-SD higher BMI=1.19, WC=1.27; FM=1.17).

  • In people with diabetes (including prediabetes and euglycemia), but not in those without, higher measures of each adiposity parameter were shown to be significantly related to higher HF risk (HR per 1-SD higher BMI=1.29, WC=1.48; FM=1.25).

  • In those with diabetes, there was a higher population attributable risk percentage of overall obesity, abdominal obesity, and high FM for incident HF (12.8%, 29.9%, 13.7%, respectively), vs those without diabetes (≤1% for each).

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