Plos Med:亚洲46家心衰中心注册研究:四肢细、肚子大的心衰患者预后最差

2019-09-26 朱柳媛 中国循环杂志

近年来,不断有证据表明,“四肢细、肚子大”(腹型肥胖)是不健康的体型。 近日发表在PLOS Medicine杂志上的一项覆盖亚洲11个地区的最新研究又增添了新证据。 该研究显示,体重指数较低、但腰围身高比较高(腹型肥胖)的心衰患者预后最差,包括射血分数保留和降低的心衰患者。 研究者指出,与西方患者相比,亚洲心衰患者整体偏瘦。在西方心衰患者中,存在“肥胖悖论”,即体重指

近年来,不断有证据表明,“四肢细、肚子大”(腹型肥胖)是不健康的体型。
 
近日发表在PLOS Medicine杂志上的一项覆盖亚洲11个地区的最新研究又增添了新证据。
 
该研究显示,体重指数较低、但腰围身高比较高(腹型肥胖)的心衰患者预后最差,包括射血分数保留和降低的心衰患者。
 
研究者指出,与西方患者相比,亚洲心衰患者整体偏瘦。在西方心衰患者中,存在“肥胖悖论”,即体重指数越高的患者预后反而越好。
 
在亚洲患者中,只有用体重指数进行评估时,才有“肥胖悖论”,用腰围身高比评估肥胖与全因死亡和心衰住院风险之间的关系,就得出了截然相反的结果。
 
分析显示,体重指数越高,患者1年心衰住院或全因死亡的风险越低。与之相反的是,腰围身高比越高,上述终点事件发生风险越高。
 
多变量分析表明,与体重指数较高(≥24.5 kg/m2)而腰围身高比较低(<0.55)的患者相比,体重指数较低(<24.5 kg/m2)而腰围身高比较高(≥0.55)的心衰患者1年时因心衰住院或全因死亡的风险增加93%。
 
研究者还发现,体重指数较低而腰围身高比较高的心衰患者以女士多见,低收入国家/地区多见(主要是南亚和东南亚地区),患者合并糖尿病的比例较高,生活质量较差。
 
该研究基于亚洲心衰患者心原性猝死(ASIAN-HF)这项前瞻性的注册登记研究,覆盖包括中国大陆、日本、韩国等在内的11个亚洲地区的46家心衰中心,纳入5964例症状性心衰患者。
 
患者的平均年龄为61.3岁,平均体重指数为25.3 kg/m2,16%为射血分数保留的心衰。其中2051例患者测量过腰围身高比,其平均体重指数为25.0 kg/m2。体重指数较低但腰围身高比较高者占13.9%。
 
原始出处:
Chanchal Chandramouli, et al. Association of obesity with heart failure outcomes in 11 Asian regions: A cohort study. PLOS Medicine, Published: September 24, 2019

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    2019-10-18 qingfengqishi5

    学习了,学习了

    0

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  6. [GetPortalCommentsPageByObjectIdResponse(id=1764769, encodeId=94551e6476942, content=<a href='/topic/show?id=c73964968de' target=_blank style='color:#2F92EE;'>#注册研究#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64968, encryptionId=c73964968de, topicName=注册研究)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=510b37798730, createdName=dlwang_26703139, createdTime=Wed Jul 22 06:09:00 CST 2020, time=2020-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1692076, encodeId=ccc916920e644, content=<a href='/topic/show?id=a450530853c' target=_blank style='color:#2F92EE;'>#患者预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53085, encryptionId=a450530853c, topicName=患者预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8f4729287700, createdName=bnurmamat, createdTime=Tue Oct 22 20:09:00 CST 2019, time=2019-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=374088, encodeId=27273e4088bf, content=学习了,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzTetibytbqFDmFITWHyBWbxU7S9MYibgPSqvu0sYteH0N6zXqbU0Kf3Mbdb7yWM1Kud3zPgYBibE2SZ/0, createdBy=da7696924, createdName=qingfengqishi5, createdTime=Fri Oct 18 21:04:57 CST 2019, time=2019-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1775706, encodeId=45f71e757064b, content=<a href='/topic/show?id=f82a51930c5' target=_blank style='color:#2F92EE;'>#心衰中心#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51930, encryptionId=f82a51930c5, topicName=心衰中心)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f3ff38785643, createdName=lilianxiang, createdTime=Sun Apr 12 03:09:00 CST 2020, time=2020-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1373457, encodeId=e30813e345774, content=<a href='/topic/show?id=2fd051939ab' target=_blank style='color:#2F92EE;'>#心衰患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51939, encryptionId=2fd051939ab, topicName=心衰患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=467c360, createdName=yuanming7, createdTime=Sat Sep 28 14:09:00 CST 2019, time=2019-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1556872, encodeId=699015568e246, content=<a href='/topic/show?id=e4016495635' target=_blank style='color:#2F92EE;'>#注册#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64956, encryptionId=e4016495635, topicName=注册)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c52c14833361, createdName=zhyy93, createdTime=Sat Sep 28 14:09:00 CST 2019, time=2019-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1609998, encodeId=f4d91609998da, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Sat Sep 28 14:09:00 CST 2019, time=2019-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=373241, encodeId=7c603e324173, content=谢谢了,学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30331616752, createdName=txqjm, createdTime=Fri Sep 27 01:36:17 CST 2019, time=2019-09-27, status=1, ipAttribution=)]
    2019-09-28 zhyy93
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    2019-09-27 txqjm

    谢谢了,学习

    0

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