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Adiposity modifies the association between heart failure risk and glucose metabolic disorder in older individuals: a community-based prospective cohort study.
- Source :
-
Cardiovascular diabetology [Cardiovasc Diabetol] 2024 Aug 27; Vol. 23 (1), pp. 318. Date of Electronic Publication: 2024 Aug 27. - Publication Year :
- 2024
-
Abstract
- Background: Glucose metabolic disorder is associated with the risk of heart failure (HF). Adiposity is a comorbidity that is inextricably linked with abnormal glucose metabolism in older individuals. However, the effect of adiposity on the association between glucose metabolic disorder and HF risk, and the underlying mechanism remain unclear.<br />Methods: A total of 13,251 participants aged ≥ 60 years from a cohort study were categorized into euglycemia, prediabetes, uncontrolled diabetes, and well-controlled diabetes. Adiposity was assessed using body mass index (BMI), waist-to-hip ratio (WHR), and visceral fat area (VFA). Adiposity-associated metabolic activities were evaluated using adiponectin-to-leptin ratio (ALR), homeostatic model assessment of insulin resistance (HOMA-IR), and triglyceride-glucose index (TyG). The first occurrence of HF served as the outcome during the follow-up period.<br />Results: A total of 1,138 participants developed HF over the course of an average follow-up period of 10.9 years. The rate of incident HF occurrence was higher in prediabetes, uncontrolled diabetes, and well-controlled diabetes participants compared to that in euglycemia participants. However, the high rates were significantly attenuated by BMI, VFA, and WHR. For WHR in particular, the hazard ratio for incident HF was 1.18 (95% confidence interval (CI): 1.03, 1.35, P <subscript>adj.</subscript> =0.017) in prediabetes, 1.59 (95% CI: 1.34, 1.90, P <subscript>adj.</subscript> <0.001) in uncontrolled diabetes, and 1.10 (95% CI: 0.85, 1.43, P <subscript>adj.</subscript> =0.466) in well-controlled diabetes. The population attributable risk percentage for central obesity classified by WHR for incident HF was 30.3% in euglycemia, 50.0% in prediabetes, 48.5% in uncontrolled diabetes, and 54.4% in well-controlled diabetes. Adiposity measures, especially WHR, showed a significant interaction with glucose metabolic disorder in incident HF (all P <subscript>adj.</subscript> <0.001). ALR was negatively associated and HOMA-IR and TyG were positively associated with BMI, WHR, VFA, and incident HF (all P <subscript>adj.</subscript> <0.05). ALR, HOMA-IR, and TyG mediated the associations for BMI, WHR and VFA with incident HF (all P <subscript>adj</subscript> .<0.05).<br />Conclusions: Adiposity attenuated the association of glucose metabolic disorder with incident HF. The results also showed that WHR may be an appropriate indicator for evaluating adiposity in older individuals. Adiposity-associated metabolic activities may have a bridging role in the process of adiposity attenuating the association between glucose metabolic disorder and incident HF.<br />Trial Registration: retrospectively registered number: ChiCTR-EOC-17,013,598.<br /> (© 2024. The Author(s).)
- Subjects :
- Humans
Male
Female
Aged
Prospective Studies
Middle Aged
Risk Assessment
Incidence
Risk Factors
Time Factors
Age Factors
Body Mass Index
Insulin Resistance
Waist-Hip Ratio
Obesity epidemiology
Obesity diagnosis
Obesity blood
Obesity physiopathology
Adiponectin blood
Diabetes Mellitus epidemiology
Diabetes Mellitus diagnosis
Diabetes Mellitus blood
Prognosis
Intra-Abdominal Fat physiopathology
Intra-Abdominal Fat metabolism
Leptin
Heart Failure epidemiology
Heart Failure diagnosis
Heart Failure blood
Heart Failure physiopathology
Adiposity
Blood Glucose metabolism
Biomarkers blood
Prediabetic State epidemiology
Prediabetic State diagnosis
Prediabetic State blood
Subjects
Details
- Language :
- English
- ISSN :
- 1475-2840
- Volume :
- 23
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Cardiovascular diabetology
- Publication Type :
- Academic Journal
- Accession number :
- 39192249
- Full Text :
- https://doi.org/10.1186/s12933-024-02418-5