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Zhou Y, Xie Y, Dong J, He K. Associations between metabolic overweight/obesity phenotypes and mortality risk among patients with chronic heart failure. Front Endocrinol (Lausanne) 2024; 15:1445395. [PMID: 39371927 PMCID: PMC11452845 DOI: 10.3389/fendo.2024.1445395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Accepted: 09/03/2024] [Indexed: 10/08/2024] Open
Abstract
Background Metabolic disorders and overweight or obesity are highly prevalent and intricately linked in patients with chronic heart failure (CHF). However, it remains unclear whether there is an interactive effect between these conditions and the prognosis of heart failure, and whether such an interaction is influenced by stratification based on age and sex. Methods A total of 4,955 patients with CHF were enrolled in this study. Metabolic status was assessed according to the presence or absence of metabolic syndrome (MetS). BMI categories included normal weight and overweight or obesity (BMI < 24, ≥ 24 kg/m2). Patients were divided into four phenotypes according to their metabolic status and BMI: metabolically healthy with normal weight (MHNW), metabolically unhealthy with normal weight (MUNW), metabolically healthy with overweight or obesity (MHO), and metabolically unhealthy with overweight or obesity (MUO). The incidence of primary outcomes, including all-cause and cardiovascular (CV) death, was recorded. Results During a mean follow-up of 3.14 years, a total of 1,388 (28.0%) all-cause deaths and 815 (16.4%) CV deaths were documented. Compared to patients with the MHNW phenotype, those with the MUNW (adjusted hazard ratio [aHR], 1.66; 95% confidence interval [CI], 1.38-2.00) or MUO (aHR, 1.42 [95% CI, 1.24-1.63]) phenotypes had a greater risk of all-cause death, and those with the MHO phenotype (aHR, 0.61 [95% CI, 0.51-0.72]) had a lower risk of all-cause death. Moreover, the above phenomenon existed mainly among males and elderly females (aged ≥ 60 years). In nonelderly females (aged < 60 years), the detrimental effects of MetS were lower (aHR, 1.05 [95% CI, 0.63-1.75] among MUNW group and aHR, 0.52 [95% CI, 0.34-0.80] among MUO group), whereas the protective effects of having overweight or obesity persisted irrespective of metabolic status (aHR, 0.43 [95% CI, 0.26-0.69] among MHO group and aHR, 0.52 [95% CI, 0.34-0.80] among MUO group). Similar results were obtained in the Cox proportional risk analysis of the metabolic overweight/obesity phenotypes and CV death. Conclusions In male and elderly female patients with CHF, the detrimental effects of MetS outweighed the protective benefits of having overweight or obesity. Conversely, in nonelderly females, the protective effects of having overweight or obesity were significantly greater than the adverse impacts of MetS.
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Affiliation(s)
- You Zhou
- School of Medicine, Nankai University, Tianjin, China
| | - Yingli Xie
- The First Affiliated Hospital, Collage of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Jingjing Dong
- The First Affiliated Hospital, Collage of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Kunlun He
- School of Medicine, Nankai University, Tianjin, China
- Medical Innovation Research Department of People’s Liberation Army General Hospital, Beijing, China
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Li X, Zhai Y, Zhao J, He H, Li Y, Liu Y, Feng A, Li L, Huang T, Xu A, Lyu J. Impact of Metabolic Syndrome and It's Components on Prognosis in Patients With Cardiovascular Diseases: A Meta-Analysis. Front Cardiovasc Med 2021; 8:704145. [PMID: 34336959 PMCID: PMC8319572 DOI: 10.3389/fcvm.2021.704145] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 06/21/2021] [Indexed: 12/13/2022] Open
Abstract
Background: Patients with metabolic syndrome (MetS) have a higher risk of developing cardiovascular diseases (CVD). However, controversy exists about the impact of MetS on the prognosis of patients with CVD. Methods: Pubmed, Cochrane library, and EMBASE databases were searched. Cohort Studies and randomized controlled trials post hoc analyses that evaluated the impact of MetS on prognosis in patients (≥18 years) with CVD were included. Relative risk (RR), hazard rate (HR) and 95% confidence intervals (CIs) were calculated for each individual study by random-effect model. Subgroup analysis and meta-regression analysis was performed to explore the heterogeneity. Results: 55 studies with 16,2450 patients were included. Compared to patients without MetS, the MetS was associated with higher all-cause death [RR, 1.220, 95% CI (1.103 to 1.349), P, 0.000], CV death [RR, 1.360, 95% CI (1.152 to 1.606), P, 0.000], Myocardial Infarction [RR, 1.460, 95% CI (1.242 to 1.716), P, 0.000], stroke [RR, 1.435, 95% CI (1.131 to 1.820), P, 0.000]. Lower high-density lipoproteins (40/50) significantly increased the risk of all-cause death and CV death. Elevated fasting plasma glucose (FPG) (>100 mg/dl) was associated with an increased risk of all-cause death, while a higher body mass index (BMI>25 kg/m2) was related to a reduced risk of all-cause death. Conclusions: MetS increased the risk of cardiovascular-related adverse events among patients with CVD. For MetS components, there was an increased risk in people with low HDL-C and FPG>100 mg/dl. Positive measures should be implemented timely for patients with CVD after the diagnosis of MetS, strengthen the prevention and treatment of hyperglycemia and hyperlipidemia.
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Affiliation(s)
- Xiao Li
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China
- Department of Clinical Medicine, Qinghai Institute of Health Sciences, Xining, China
| | - Yajing Zhai
- Department of Pharmacy, The First Affiliated Hospital of Xi'an Medical University, Xi'an, China
| | - Jiaguo Zhao
- Department of Orthopaedic Surgery, Tianjin Hospital, Tianjin, China
| | - Hairong He
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yuanjie Li
- Department of Human Anatomy, Histology and Embryology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Yue Liu
- Xiyuan Hospital of China Academy of Chinese Medicinal Sciences, Beijing, China
| | - Aozi Feng
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Li Li
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Tao Huang
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Anding Xu
- Department of Neurology, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Jun Lyu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China
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Huang ZM, Chen WR, Su QW, Huang ZW. Prognostic Impact of Metabolic Syndrome in Patients With Heart Failure: A Meta-Analysis of Observational Studies. Front Cardiovasc Med 2021; 8:704446. [PMID: 34250051 PMCID: PMC8263914 DOI: 10.3389/fcvm.2021.704446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 05/21/2021] [Indexed: 12/16/2022] Open
Abstract
Background: The metabolic syndrome (MS) is significantly associated with the risk of incident heart failure (HF). However, there are still great controversies about the impact of MS on the prognosis in patients with established HF. This meta-analysis aimed to ascertain the effect of MS on the prognosis in patients with HF. Methods: We searched multiple electronic databases, including PubMed, Opengrey, EMBASE, and Cochran Library, for potential studies up to February 15, 2021. Observational studies that reported the impact of MS on the prognosis in patients with established HF were included for meta-analysis. Results: Ten studies comprising 18,590 patients with HF were included for meta-analysis. The median follow-up duration of the included studies was 2.4 years. Compared with HF patients without MS, the risk of all-cause mortality and cardiovascular mortality was not increased in HF with MS (HR = 1.04, 95% CI = 0.88–1.23 for all-cause mortality; HR = 1.66, 95% CI = 0.56–4.88 for cardiovascular mortality, respectively). However, there was a significant increase in composited cardiovascular events in the HF patients with MS compared with those without MS (HR = 1.73, 95% CI = 1.23–2.45). Conclusions: In patients with established HF, the presence of MS did not show an association on the risk of all-cause mortality or cardiovascular mortality, while it may increase the risk of composite cardiovascular events.
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Affiliation(s)
- Zhuo-Ming Huang
- Department of Internal Medicine, Xingtan Hospital Affiliated to Shunde Hospital of Southern Medical University, Foshan, China
| | - Wen-Rong Chen
- Department of Internal Medicine, Xingtan Hospital Affiliated to Shunde Hospital of Southern Medical University, Foshan, China
| | - Qi-Wen Su
- Department of Internal Medicine, Xingtan Hospital Affiliated to Shunde Hospital of Southern Medical University, Foshan, China
| | - Zhuo-Wen Huang
- Department of Internal Medicine, Xingtan Hospital Affiliated to Shunde Hospital of Southern Medical University, Foshan, China
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Kimura Y, Okumura T, Kazama S, Shibata N, Oishi H, Arao Y, Kuwayama T, Kato H, Yamaguchi S, Hiraiwa H, Kondo T, Morimoto R, Murohara T. Usefulness of Plasma Branched-Chain Amino Acid Analysis in Predicting Outcomes of Patients with Nonischemic Dilated Cardiomyopathy. Int Heart J 2020; 61:739-747. [DOI: 10.1536/ihj.20-010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Yuki Kimura
- Department of Cardiology, Nagoya University Graduate School of Medicine
| | - Takahiro Okumura
- Department of Cardiology, Nagoya University Graduate School of Medicine
| | - Shingo Kazama
- Department of Cardiology, Nagoya University Graduate School of Medicine
| | - Naoki Shibata
- Department of Cardiology, Nagoya University Graduate School of Medicine
| | - Hideo Oishi
- Department of Cardiology, Nagoya University Graduate School of Medicine
| | - Yoshihito Arao
- Department of Cardiology, Nagoya University Graduate School of Medicine
| | - Tasuku Kuwayama
- Department of Cardiology, Nagoya University Graduate School of Medicine
| | - Hiroo Kato
- Department of Cardiology, Nagoya University Graduate School of Medicine
| | - Shogo Yamaguchi
- Department of Cardiology, Nagoya University Graduate School of Medicine
| | - Hiroaki Hiraiwa
- Department of Cardiology, Nagoya University Graduate School of Medicine
| | - Toru Kondo
- Department of Cardiology, Nagoya University Graduate School of Medicine
| | - Ryota Morimoto
- Department of Cardiology, Nagoya University Graduate School of Medicine
| | - Toyoaki Murohara
- Department of Cardiology, Nagoya University Graduate School of Medicine
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Functional Capacity but Not Early Uptake of Cardiac Rehabilitation Predicts Readmission in Patients With Metabolic Syndrome. J Cardiovasc Nurs 2019; 33:306-312. [PMID: 29303869 DOI: 10.1097/jcn.0000000000000454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Phase II cardiac rehabilitation reduces hospital readmissions and cardiovascular disease risk factors and improves functional capacity. Cardiovascular disease risk factors double with patients with metabolic syndrome, a population less likely to adhere to cardiac rehabilitation. PURPOSE The aim of this study was to determine relationships between cardiac rehabilitation uptake timing, demographic variables and functional capacity, and readmission in patients with metabolic syndrome. METHODS This retrospective, medical records study involved 353 patients with metabolic syndrome who subsequently received cardiac rehabilitation. Logistic regression was used to examine relationships between time from discharge to cardiac rehabilitation uptake and readmission. Unordered categorical factors were compared between readmission groups using Pearson χ tests. Multivariable logistic regression was used to identify predictors of readmission. RESULTS Patients readmitted within 30 and 90 days of hospitalization were more often women (P ≤ .018) and nonwhite (P ≤ .002) and had lower functional capacity (P < .001). In multivariable analysis, white race (odds ratio [OR], 0.50 [95% confidence interval (CI), 0.25-0.99]; P = .045) and higher functional capacity (OR, 0.80 [95% CI, 0.68-0.93]; P = .005) were protective against hospital readmission within the first 90 days. Race, sex, and functional capacity remained significant predictors of readmission at 1 year. In multivariable analysis, only race (OR, 0.41 [95% CI, 0.22-0.79]; P = .007) and functional capacity (OR, 0.83 [95% CI, 0.73-0.95]; P = .007) were significant. Early cardiac rehabilitation was not associated with readmission at any time point (P > .05). CONCLUSIONS Sex, race, and functional capacity were important predictors of readmission for metabolic syndrome, even when cardiac rehabilitation intake was delayed. Results raise questions about the unique traits of patients with metabolic syndrome and need for novel approaches to improve cardiac rehabilitation utilization and functional capacity in metabolic syndrome.
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Timóteo AT, Mota Carmo M, Soares C, Cruz Ferreira R. Is metabolic syndrome a prognostic marker in patients at high cardiovascular risk? A long-term cohort study. Rev Port Cardiol 2019; 38:325-332. [PMID: 31221487 DOI: 10.1016/j.repc.2018.06.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 06/18/2018] [Accepted: 06/24/2018] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Obese patients are at higher cardiovascular risk in primary prevention. In secondary prevention, an obesity paradox has been reported. We analyzed a cohort of individuals from a previous cross-sectional study on the impact of metabolic syndrome (MS) on coronary artery disease (CAD), aiming to assess the occurrence of cardiovascular events in a long follow-up. METHODS We analyzed 296 individuals in a mean follow-up of 6.9±2.2 years. Subjects were divided into four groups according to the presence of MS or CAD (defined as ≥70% coronary stenosis). RESULTS The study population had a mean age of 65±9 years at the beginning of the study; 59.5% were male, 55.7% had MS and 41.6% had CAD. During follow-up 10.1% of the population suffered all-cause death, 3.7% cardiovascular death, 14.2% cardiovascular readmission and 22.0% the composite outcome (mortality, acute coronary syndrome, coronary revascularization, stroke/transient ischemic attack or heart failure admission). There were no significant differences in any type of mortality. Patients with CAD had more readmissions and composite outcomes (log-rank p<0.001 and p=0.001, respectively), but there was no difference according to the presence of MS. Only CAD was an independent predictor of cardiovascular admission (HR 3.21, 95% CI 1.66-6.21) and composite outcomes (HR 2.41, 95% CI 1.44-4.02). CONCLUSIONS In patients with high cardiovascular risk or established CAD, the presence of MS is not associated with cerebral or cardiac events in long-term follow-up.
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Affiliation(s)
- Ana Teresa Timóteo
- Serviço de Cardiologia, Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisboa, Portugal; Centro de Estudos de Doenças Crónicas (CEDOC), NOVA Medical School, Lisboa, Portugal.
| | - Miguel Mota Carmo
- Centro de Estudos de Doenças Crónicas (CEDOC), NOVA Medical School, Lisboa, Portugal
| | - Cristina Soares
- Serviço de Cardiologia, Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisboa, Portugal
| | - Rui Cruz Ferreira
- Serviço de Cardiologia, Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisboa, Portugal
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Hitsumoto T. Relationships Between Skin Autofluorescence and Cardio-Ankle Vascular Index in Japanese Male Patients With Metabolic Syndrome. Cardiol Res 2019; 10:172-180. [PMID: 31236180 PMCID: PMC6575114 DOI: 10.14740/cr878] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 05/30/2019] [Indexed: 01/05/2023] Open
Abstract
Background An autofluorescence (AF) reader can be used to noninvasively measure tissues that accumulated advanced glycation end-products to diagnose skin AF. This study aimed to clarify the clinical significance of skin AF as a risk factor for cardiovascular disease in Japanese male patients with metabolic syndrome using the cardio-ankle vascular index (CAVI) as a marker of arterial function. Methods This cross-sectional study enrolled 261 Japanese male patients with metabolic syndrome without history of cardiovascular disease (mean age, 58 ± 7 years (mean ± standard deviation)). Associations between skin AF and various clinical parameters including CAVI were examined. Results Skin AF was significantly positively correlated with CAVI (r = 0.40, P < 0.001). Furthermore, multiple regression analyses revealed that skin AF (β = 0.18, P = 0.002) was selected as an independent subordinate factor for CAVI. Meanwhile, homeostatic model assessment of insulin resistance (HOMA-IR) as a marker of insulin resistance, smoking habits and high-sensitivity C-reactive protein as an inflammation marker were independent variables for either CAVI or skin AF as a subordinate factor. According to the receiver-operating characteristic curve analysis and results of previous reports that determined CAVI of ≥ 9.0 as a diagnostic criterion for vascular failure, skin AF of > 2.7 arbitrary unit is the optimal cut-off point for discriminating high CAVI (area under the curve = 0.718, P < 0.001). Conclusion Findings in this study indicate that skin AF may be an important risk factor of cardiovascular disease in Japanese male patients with metabolic syndrome. In addition, the risk value of skin AF was considered as higher than 2.7 arbitrary unit. Further investigations in a large number of prospective studies, including intervention therapies, are required to validate the results in this study.
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Affiliation(s)
- Takashi Hitsumoto
- Hitsumoto Medical Clinic, 2-7-7, Takezakicyou, Shimonoseki City, Yamaguchi 750-0025, Japan.
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Is metabolic syndrome a prognostic marker in patients at high cardiovascular risk? A long-term cohort study. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2019. [DOI: 10.1016/j.repce.2018.06.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Cattafesta M, Salaroli LB. Diets high in vegetables, fruits, cereals, and tubers as a protective factor for metabolic syndrome in bank employees. Diabetes Metab Syndr Obes 2018; 11:781-790. [PMID: 30538515 PMCID: PMC6254587 DOI: 10.2147/dmso.s184716] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The prevalence of metabolic syndrome (MetS) is increasing, and its development may be related to westernized diets and working conditions. PURPOSE The purpose of this study was to evaluate the association of dietary patterns in bank employees with the presence of MetS, considering sociodemographic and behavioral factors as well as laboratory tests. SUBJECTS AND METHODS This was a cross-sectional study of 515 bankers. Sociodemographic, occupational, behavioral, and food consumption data were collected. Dietary patterns were determined by principal component analysis with orthogonal varimax rotation. RESULTS The dietary pattern of vegetables, fruits, cereals, and tubers was correlated with the presence of MetS and with waist circumference measurements and triglyceride levels. Individuals in the third and fifth quintiles of the pattern "vegetables, fruits, cereals, and tubers" presented with 3.28 and 2.24 times less chances of MetS when compared to individuals in the first quintile of this dietary pattern (OR 0.30, 95% CI 0.13-0.67, and OR 0.44, 95% CI 0.21-0.92, respectively). Subjects over 45 years of age were almost twice as likely to develop MetS (OR 1.95, 95% CI 1.01-3.77). CONCLUSION Healthy eating represented by the dietary pattern "vegetables, fruits, cereals, and tubers" was associated with better health among bank employees, especially when evaluating competing metabolic complications such as MetS.
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Affiliation(s)
- Monica Cattafesta
- Postgraduate Program in Public Health, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Luciane Bresciani Salaroli
- Postgraduate Program in Public Health, Postgraduate Program in Nutrition and Health, Department of Health Integrated Education, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil,
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Seo Y, Aonuma K. Gamma-Glutamyl Transferase as a Risk Biomarker of Cardiovascular Disease - Does It Have Another Face? Circ J 2017; 81:783-785. [PMID: 28450670 DOI: 10.1253/circj.cj-17-0409] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Yoshihiro Seo
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
| | - Kazutaka Aonuma
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
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