Update on obesity, the obesity paradox, and obesity management in heart failure

Alebna, Pamela L.; Mehta, Anurag; Yehya, Amin; daSilva-deAbreu, Adrian; Lavie, Carl J.; Carbone, Salvatore

doi:10.1016/j.pcad.2024.01.003

Cited by 23 publications

(1 citation statement)

References 64 publications

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“…Obesity will cause a third of the rise in diabetes cases by 2030, affecting 9.5% of adults (Grant, et al, 2021). In addition, it is well-known that high-fat accumulation is also a major cause of cardiovascular disease in obesity (Alebna et al, 2024). Previous studies have shown that the incidence of obesity is strongly correlated with low adiponectin levels (<2 µg/mL) or hypoadiponectinemia (Robinson et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Effects of moderate-intensity combination exercise on increase adiponectin levels, muscle mass, and decrease fat mass in obese women

Andarianto,

Rejeki,

Pranoto

et al. 2024

Retos

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Obesity is reported to be strongly associated with low levels of adiponectin, which may be involved in metabolic syndrome, insulin resistance, cardiovascular disease, hypertension, and cancer cell proliferation. Meanwhile, physical exercise has been reported to increase adiponectin levels and decrease insulin resistance in obese individuals. Therefore, this study aimed to prove the effects of four weeks of moderate-intensity combination exercise (aerobic and resistance) on increasing adiponectin levels, skeletal muscle mass (SMM), and decreasing fat mass (FM) in obese women. A total of 14 obese adolescent women aged 20-24 years with a body mass index (BMI) of 27.5-36.5 kg/m2 (based on Asia-Pacific BMI classification) were selected as research subjects and divided into two intervention groups: control (CON) and moderate-intensity combination exercise (MCE) groups. The ELISA kit method was used to analyze pre- and post-exercise adiponectin levels, while the mBCA 554 seca was used to measure BMI, FM, and SMM. Statistical analysis was performed using an independent samples t-test with a 5% significance level. The data showed ∆-BMI between CON and MCE (0.54±0.99 vs -1.31±0.19 kg/m2; p = 0.001), ∆-FM (1.56±3.89 vs -3.60±1.16 kg; p = 0.006), ∆-SMM (-0.85±1.91 vs 3.61±0.74 kg; p = 0.001), ∆-Adiponectin (0.55±2.39 vs 15.45±6.21 ng/mL; p = 0.001). The results demonstrate that a 4-week moderate-intensity combination exercise intervention effectively increases adiponectin levels and skeletal muscle mass and reduces body mass index and fat mass in obese women. Keywords: Obesity, combination exercise, adiponectin levels, body composition.

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Section: Introductionmentioning

confidence: 99%

Effects of moderate-intensity combination exercise on increase adiponectin levels, muscle mass, and decrease fat mass in obese women

Andarianto,

Rejeki,

Pranoto

et al. 2024

Retos

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Obesity Paradox and the Effect of NT‐proBNP on All‐Cause and Cause‐Specific Mortality

Bahniwal,

Sadr,

Schinderle

et al. 2024

Clinical Cardiology

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BackgroundIn heart failure patients, obesity is associated with better outcomes as compared to normal weight, a phenomenon called the obesity paradox.ObjectiveTo examine if obesity modifies the relationship between NT‐proBNP and all‐cause and cause‐specific mortality in adults without coronary artery disease or heart failure history.MethodsWe used the National Health and Nutrition Examination Survey (NHANES) data from 1999 to 2004 and linked it with mortality through December 31, 2019. Participants > 18 years were categorized into normal weight (BMI ≤ 25 kg/m2), overweight (BMI > 25–29.9 kg/m2) and obese (BMI > 29.9 kg/m2). NT‐proBNP levels were categorized as low (< 126 pg/mL) or high (≥ 126 pg/mL). Using Cox proportional hazard models, we examined effect modification by obesity using interaction, without and with adjusting for potential confounders.ResultsOf the 12 621 participants, 2794 (22%) died during 202 859 person‐years follow‐up. In adjusted models, normal‐weight participants with high NT‐proBNP had 2 times higher all‐cause mortality risk than those with low NT‐proBNP (HR = 2.05; 95%CI = 1.74, 2.41; p < 0.001); however, this mortality risk was 27% lower in obese participants (HR interaction = 0.73; 95%CI = 0.59, 0.92; p = 0.008). Similarly, in normal‐weight participants, the difference in other‐cause mortality risk between high and low NT‐proBNP participants was significant in adjusted models (HR = 2.27; 95%CI = 1.81, 2.85; p < 0.001) and obese participants had 48% lower other‐cause mortality risk between those with high and low NT‐proBNP (interaction HR = 0.52; 95%CI = 0.36, 0.77; p = 0.001). Conversely, obesity did not modify the relationship between NT‐proBNP and cardiovascular or cancer mortality.ConclusionsIn patients free of heart failure or coronary artery disease, obesity may be protective against mortality associated with high NT‐proBNP.

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Prognostic impact of being underweight in patients undergoing mitral TEER: The OCEAN‐Mitral registry

Higuchi,

Izumo,

Izumi

et al. 2024

ESC Heart Failure

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AimsMitral transcatheter edge‐to‐edge repair (M‐TEER) is a valid treatment option for severe mitral regurgitation (MR), necessitating accurate risk stratification of M‐TEER candidates for effective patient selection, optimal periprocedural care and improved long‐term outcomes. The body mass index (BMI) is a simple and practical prognostic index, and the obesity paradox has been widely reported.Methods and ResultsBetween April 2018 and June 2021, 2149 patients undergoing M‐TEER were registered in the prospective multicentre registry and classified into three groups: underweight (BMI < 18.5 kg/m2), normal weight (18.5 ≦ BMI < 25 kg/m2) and overweight and obese (25 kg/m2 ≦ BMI). The impact of underweight on the all‐cause, cardiovascular and non‐cardiovascular mortality following M‐TEER was evaluated [follow‐up duration: 436 (363–733) days]. The participants (median BMI: 21.1 kg/m2) were categorized as underweight (n = 450, 20.9%), normal weight (n = 1409, 65.6%) and overweight and obese (n = 290, 13.5%). Compared with the other two groups, the underweight group exhibited several negative prognostic factors, including older age, frailty, no dyslipidaemia, hypoalbuminaemia, residual MR and non‐home discharge. Underweight patients had the highest rate of all‐cause, cardiovascular and non‐cardiovascular mortality, whereas those in the other two groups were similar. As per the multivariate analysis, underweight itself was associated with all‐cause mortality (hazard ratio: 1.52, 95% confidence interval: 1.17–1.97, P = 0.009) and cardiovascular mortality (hazard ratio: 1.45, 95% confidence interval: 1.04–2.01, P = 0.028).ConclusionsUnderweight patients had the highest mortality rate after M‐TEER. Comorbidities, residual MR, discharge disposition and underweight status were correlated with postprocedural outcome.

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Update on obesity, the obesity paradox, and obesity management in heart failure

Cited by 23 publications

References 64 publications

Effects of moderate-intensity combination exercise on increase adiponectin levels, muscle mass, and decrease fat mass in obese women

Effects of moderate-intensity combination exercise on increase adiponectin levels, muscle mass, and decrease fat mass in obese women

Obesity Paradox and the Effect of NT‐proBNP on All‐Cause and Cause‐Specific Mortality

Prognostic impact of being underweight in patients undergoing mitral TEER: The OCEAN‐Mitral registry

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