Regional fat distribution as a determinant of mortality in populations with left ventricular systolic dysfunction: challenging the obesity paradox - PubMed
3 hours ago
- #Obesity
- #Cardiology
- #Prognosis
- In individuals with left ventricular systolic dysfunction, central adiposity measures (waist circumference and waist-to-hip ratio) are more strongly associated with cardiovascular and all-cause mortality than BMI or general adiposity measures.
- The study included 5,615 participants from the UK Biobank Imaging Enhancement Programme with CMR-defined LV systolic impairment and followed them for a median of 13.5 years.
- Central adiposity measures showed stronger hazard ratios for mortality (e.g., waist circumference: all-cause HR 1.25, CV HR 1.49) compared to BMI (all-cause HR 1.19, CV HR 1.37).
- Inclusion of waist circumference and waist-to-hip ratio in risk models led to statistically significant improvements in discrimination for mortality prediction over BMI-based models.
- The findings challenge the obesity paradox by emphasizing that fat distribution, particularly abdominal fat, is a more critical prognostic factor than overall adiposity in this population.