Epidemiology and Health

Original Articles

The association between metabolic syndrome and heart failure in middle-aged male and female: Korean population-based study of 2 million individuals: Tae-Eun Kim, Hyeongsu Kim, JiDong Sung, Duk-Kyung Kim, Myoung-Soon Lee, Seong Woo Han, Hyun-Joong Kim, Sung Hea Kim, Kyu-Hyung Ryu; Epidemiol Health. 2022;44:e2022078. Published online September 21, 2022; DOI: https://doi.org/10.4178/epih.e2022078

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Abstract

OBJECTIVES
Although an association is known to exist between metabolic syndrome (MetS) and heart failure (HF) risk, large longitudinal studies are limited. We investigated metabolic status as a risk factor for HF in middle-aged male and female and considered sex differences in various risk factors for HF using nationwide real-world data.

METHODS

Data obtained from the Korean National Health Insurance Service from 2009 to 2016 were analyzed. A total of 2,151,597 middle-aged subjects (between 50 and 59 years old) were enrolled. Subjects were divided into 3 groups (normal, pre‐ MetS, and MetS). Cox proportional hazard models were used to estimate the association between MetS and incident HF after adjusting for clinical risk factors.

RESULTS

At baseline, MetS existed in 23.77% of male and 10.58% of female. Pre-MetS and MetS increased the risk of HF: the hazard ratios of pre-MetS for incident HF were 1.508 (95% confidence interval [CI], 1.287 to 1.767) in male and 1.395 (95% CI, 1.158 to 1.681) in female, and those of MetS were 1.711 (95% CI, 1.433 to 2.044) in male and 2.144 (95% CI, 1.674 to 2.747) in female. Current smoking, a low hemoglobin level, underweight (body mass index < 18.5 kg/m2), a high creatinine level, and acute myocardial infarction were also predictors of HF in both sexes.

CONCLUSIONS

Pre-MetS and MetS were identified as risk factors for HF in middle-aged male and female. The effect of MetS on the occurrence of HF was stronger in female than in male. Pre-MetS was also a predictor of HF, but was associated with a lower risk than MetS.

Summary

Citations

Citations to this article as recorded by

Integrating machine learning and nontargeted plasma lipidomics to explore lipid characteristics of premetabolic syndrome and metabolic syndrome
Xinfeng Huang, Qing He, Haiping Hu, Huanhuan Shi, Xiaoyang Zhang, Youqiong Xu
Frontiers in Endocrinology.2024;[Epub] CrossRef
17-year follow-up of association between telomere length and all-cause mortality, cardiovascular mortality in individuals with metabolic syndrome: results from the NHANES database prospective cohort study
Lijiao Xiong, Guangyan Yang, Tianting Guo, Zhaohao Zeng, Tingfeng Liao, Yanchun Li, Ying Li, Fujuan Chen, Shu Yang, Lin Kang, Zhen Liang
Diabetology & Metabolic Syndrome.2023;[Epub] CrossRef
Modifications of long-term heart rate variability produced in an experimental model of diet-induced metabolic syndrome
W. M. Lozano, J. E. Ortiz-Guzmán, O. Arias-Mutis, A. Bizy, P. Genovés, L. Such-Miquel, A. Alberola, F. J. Chorro, M. Zarzoso, C. J. Calvo
Interface Focus.2023;[Epub] CrossRef

Adjusting for reverse causation to estimate the effect of obesity on mortality after incident heart failure in the Atherosclerosis Risk in Communities (ARIC) study: Maryam Shakiba, Hamid Soori, Mohammad Ali Mansournia, Seyed Saeed Hashemi Nazari, Yahya Salimi; Epidemiol Health. 2016;38:e2016025. Published online June 4, 2016; DOI: https://doi.org/10.4178/epih.e2016025

15,780 View
243 Download
4 Web of Science
5 Crossref

Abstract PDF

Abstract

OBJECTIVES
The lower mortality rate of obese patients with heart failure (HF) has been partly attributed to reverse causation bias due to weight loss caused by disease. Using data about weight both before and after HF, this study aimed to adjust for reverse causation and examine the association of obesity both before and after HF with mortality.

METHODS

Using the Atherosclerosis Risk in Communities (ARIC) study, 308 patients with data available from before and after the incidence of HF were included. Pre-morbid and post-morbid obesity were defined based on body mass index measurements at least three months before and after incident HF. The associations of pre-morbid and post-morbid obesity and weight change with survival after HF were evaluated using a Cox proportional hazard model.

RESULTS

Pre-morbid obesity was associated with higher mortality (hazard ratio [HR], 1.61; 95% confidence interval [CI], 1.04 to 2.49) but post-morbid obesity was associated with increased survival (HR, 0.57; 95% CI, 0.37 to 0.88). Adjusting for weight change due to disease as a confounder of the obesity-mortality relationship resulted in the absence of any significant associations between post-morbid obesity and mortality.

CONCLUSIONS

This study demonstrated that controlling for reverse causality by adjusting for the confounder of weight change may remove or reverse the protective effect of obesity on mortality among patients with incident HF.

Summary

Citations

Citations to this article as recorded by

Prevalence and clinical characteristics of diabetic cardiomyopathy in patients with acute heart failure
Kenichi Matsushita, Kazumasa Harada, Takashi Kohno, Hiroki Nakano, Daisuke Kitano, Junya Matsuda, Makoto Takei, Hideaki Yoshino, Takeshi Yamamoto, Ken Nagao, Morimasa Takayama
Nutrition, Metabolism and Cardiovascular Diseases.2024; 34(5): 1325. CrossRef
Impact of body mass index on cardiac adrenergic derangement in heart failure patients: a 123I-mIBG imaging study
Klara Komici, Leonardo Bencivenga, Stefania Paolillo, Paola Gargiulo, Roberto Formisano, Roberta Assante, Carmela Nappi, Fabio Marsico, Adriana D’Antonio, Giovanni De Simini, Antonio Cittadini, Dino Franco Vitale, Alberto Cuocolo, Pasquale Perrone Filardi
European Journal of Nuclear Medicine and Molecular Imaging.2020; 47(7): 1713. CrossRef
Impact of prior bariatric surgery on outcomes of hospitalized patients with heart failure: a population-based study
Hedong Han, Tiantian Zhu, Yibin Guo, Yiming Ruan, Eyal Herzog, Jia He
Surgery for Obesity and Related Diseases.2019; 15(3): 469. CrossRef
Body mass index and all-cause mortality in patients with atrial fibrillation: insights from the China atrial fibrillation registry study
Lu Wang, Xin Du, Jian-Zeng Dong, Wen-Na Liu, Ying-Chun Zhou, Song-Nan Li, Xue-Yuan Guo, Chen-Xi Jiang, Rong-Hui Yu, Cai-Hua Sang, Ri-Bo Tang, De-Yong Long, Nian Liu, Rong Bai, Laurent Macle, Chang-Sheng Ma
Clinical Research in Cardiology.2019; 108(12): 1371. CrossRef
The Effects of Reverse Causality and Selective Attrition on the Relationship Between Body Mass Index and Mortality in Postmenopausal Women
Hailey R Banack, Jennifer W Bea, Jay S Kaufman, Andrew Stokes, Candyce H Kroenke, Marcia L Stefanick, Shirley A Beresford, Chloe E Bird, Lorena Garcia, Robert Wallace, Robert A Wild, Bette Caan, Jean Wactawski-Wende
American Journal of Epidemiology.2019; 188(10): 1838. CrossRef

Risk factors for heart failure in a cohort of patients with newly diagnosed myocardial infarction: a matched, case-control study in Iran: Ali Ahmadi, Koorosh Etemad, Arsalan Khaledifar; Epidemiol Health. 2016;38:e2016019. Published online May 17, 2016; DOI: https://doi.org/10.4178/epih.e2016019

19,455 View
215 Download
12 Web of Science
10 Crossref

Abstract PDF

Abstract

OBJECTIVES
Risk factors for heart failure (HF) have not yet been studied in myocardial infarction (MI) patients in Iran. This study was conducted to determine these risk factors.

METHODS

In this nationwide, hospital-based, case-control study, the participants were all new MI patients hospitalized from April 2012 to March 2013 in Iran. The data on 1,691 new cases with HF (enrolled by census sampling) were compared with the data of 6,764 patients without HF as controls. We randomly selected four controls per one case, matched on the date at MI and HF diagnosis, according to incidence density sampling. Using conditional logistic regression models, odds ratios (ORs) with a 95% confidence interval (CI) were calculated to identify potential risk factors.

RESULTS

The one-year in-hospital mortality rate was 18.2% in the cases and higher than in the controls (12.1%) (p<0.05). Significant risk factors for HF were: right bundle branch block (RBBB) (OR, 2.86; 95% CI, 1.95 to 4.19), stroke (OR, 2.00; 95% CI, 1.39 to 2.89), and coronary artery bypass grafting (CABG) (OR, 2.03; 95% CI, 1.34 to 3.09). Diabetes, hypertension, percutaneous coronary intervention (PCI), atrial fibrillation, ventricular tachycardia, and age were determined to be the factors significantly associated with HF incidence (p<0.05). The most important factor in women was diabetes (OR, 1.41; 95% CI, 1.05 to 1.88). Age, hypertension, PCI, CABG, and RBBB were the most important factors in men.

CONCLUSIONS

Our findings may help to better identify and monitor the predictive risk factors for HF in MI patients. The pattern of risk factors was different in men and women.

Summary

Citations

Citations to this article as recorded by

Efficacy of a self-monitoring traffic light diary on outcomes of patients with heart failure: A randomized controlled trial
Mahin Nomali, Ramin Mohammadrezaei, Mehdi Yaseri, Amirhossein Tayebi, Aryan Ayati, Gholamreza Roshandel, Abbasali Keshtkar, Shahrzad Ghiyasvandian, Kian Alipasandi, Hossein Navid, Masoumeh Zakerimoghadam
International Journal of Nursing Studies.2024; 152: 104704. CrossRef
The feasibility and acceptability of an early tele-palliative care intervention to improve quality of life in heart failure patients in Iran: A protocol for a randomized controlled trial
Arvin Mirshahi, Shahrzad Ghiasvandian, Meysam Khoshavi, Seyed Mohammad Riahi, Ali Khanipour-Kencha, Marie Bakitas, J. Nicholas Dionne-Odom, Rachel Wells, Masoumeh Zakerimoghadam
Contemporary Clinical Trials Communications.2023; 33: 101114. CrossRef
Predictions of adherence to treatment in patients referred to the heart failure clinic of shahid rajaee hospital in Tehran
Asma Shojaee, AmirVahedian Azimi, Nasim Naderi, MohammadMehdi Salaree, Fakhrudin Faizi
Research in Cardiovascular Medicine.2023; 12(1): 8. CrossRef
Impact of Teaching Social Problem-Solving Skills on Quality of Life of Patients with Congestive Heart Failure
Sepideh Omidi, Keivan Kakabaraei, Asadollah Amiripour
Jundishapur Journal of Health Sciences.2023;[Epub] CrossRef
Medication Adherence and Health Literacy in Patients with Heart Failure: A Cross-Sectional Survey in Iran
Soheila Rezaei, Fatemeh Vaezi, Golnaz Afzal, Nasim Naderi, Gholamhossein Mehralian
HLRP: Health Literacy Research and Practice.2022;[Epub] CrossRef
A prospective survey of atrial fibrillation management in Iran: Baseline results of the Iranian Registry of Atrial Fibrillation (IRAF)
Mona Heidarali, Hooman Bakhshandeh, Reza Golpira, Amirfarjam Fazelifar, Abolfath Alizadeh‐Diz, Zahra Emkanjoo, Shabnam Madadi, Farzad Kamali, Majid Maleki, Gregory Y. H. Lip, Majid Haghjoo
International Journal of Clinical Practice.2021;[Epub] CrossRef
Gender based survival prediction models for heart failure patients: A case study in Pakistan
Faisal Maqbool Zahid, Shakeela Ramzan, Shahla Faisal, Ijaz Hussain, Olalekan Uthman
PLOS ONE.2019; 14(2): e0210602. CrossRef
Relationship of the ORBIT and HAS-BLED scores with Killip class 3-4 in patients with ST-segment elevation myocardial infarction
Qing Zhang, Lei Zhou, Hong-Li Cai, Hui-He Lu
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Survival rate and predictors of mortality in patients hospitalised with heart failure: a cohort study on the data of Persian registry of cardiovascular disease (PROVE)
Mahshid Givi, Davood Shafie, Fatemeh Nouri, Mohammad Garakyaraghi, Ghasem Yadegarfar, Nizal Sarrafzadegan
Postgraduate Medical Journal.2018; 94(1112): 318. CrossRef
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JMIR Research Protocols.2018; 7(11): e184. CrossRef

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