Obesity Paradox: Comparison of Heart Failure Patients With and Without Comorbid Diabetes

Cardiovascular Critical Care| March 01 2017 Obesity Paradox: Comparison of Heart Failure Patients With and Without Comorbid Diabetes Kyoung Suk Lee, RN, PhD, MPH; Kyoung Suk Lee, RN, PhD, MPH Kyoung Suk Lee is an assistant professor, Chungnam National University, College of Nursing, Dae Jeon, South Korea. Debra K. Moser is a professor, the Gill Endowed Chair of Nursing, and a codirector of the RICH Heart Program, University of Kentucky, College of Nursing, Lexington, Kentucky, and a professor of cardiovascular nursing, University of Ulster, Belfast, Ireland. Terry A. Lennie is a professor and a codirector of the RICH Heart Program, University of Kentucky, College of Nursing. Michele M. Pelter is an assistant professor and Kathleen Dracup is a professor emeritus, University of California San Francisco, School of Nursing, San Francisco, California. Thomas Nesbitt is a professor and associate vice chancellor for strategic technologies and alliances, and Jeffrey A. Southard is an associate clinical professor of medicine, and director of the transcatheter aortic valve replacement program, University of California, Davis, California. Corresponding author: Kyoung Suk Lee, rn, phd, mph, Assistant Professor, Chungnam National University, College of Nursing, 6 Moonhwa 1-dong, Jungu, Dae Jeon 301-747, South Korea (e-mail: kslee14@cnu.ac.kr). Search for other works by this author on: This Site PubMed Google Scholar Debra K. Moser, RN, PhD; Debra K. Moser, RN, PhD Kyoung Suk Lee is an assistant professor, Chungnam National University, College of Nursing, Dae Jeon, South Korea. Debra K. Moser is a professor, the Gill Endowed Chair of Nursing, and a codirector of the RICH Heart Program, University of Kentucky, College of Nursing, Lexington, Kentucky, and a professor of cardiovascular nursing, University of Ulster, Belfast, Ireland. Terry A. Lennie is a professor and a codirector of the RICH Heart Program, University of Kentucky, College of Nursing. Michele M. Pelter is an assistant professor and Kathleen Dracup is a professor emeritus, University of California San Francisco, School of Nursing, San Francisco, California. Thomas Nesbitt is a professor and associate vice chancellor for strategic technologies and alliances, and Jeffrey A. Southard is an associate clinical professor of medicine, and director of the transcatheter aortic valve replacement program, University of California, Davis, California. Search for other works by this author on: This Site PubMed Google Scholar Terry A. Lennie, RN, PhD; Terry A. Lennie, RN, PhD Kyoung Suk Lee is an assistant professor, Chungnam National University, College of Nursing, Dae Jeon, South Korea. Debra K. Moser is a professor, the Gill Endowed Chair of Nursing, and a codirector of the RICH Heart Program, University of Kentucky, College of Nursing, Lexington, Kentucky, and a professor of cardiovascular nursing, University of Ulster, Belfast, Ireland. Terry A. Lennie is a professor and a codirector of the RICH Heart Program, University of Kentucky, College of Nursing. Michele M. Pelter is an assistant professor and Kathleen Dracup is a professor emeritus, University of California San Francisco, School of Nursing, San Francisco, California. Thomas Nesbitt is a professor and associate vice chancellor for strategic technologies and alliances, and Jeffrey A. Southard is an associate clinical professor of medicine, and director of the transcatheter aortic valve replacement program, University of California, Davis, California. Search for other works by this author on: This Site PubMed Google Scholar Michele M. Pelter, RN, PhD; Michele M. Pelter, RN, PhD Kyoung Suk Lee is an assistant professor, Chungnam National University, College of Nursing, Dae Jeon, South Korea. Debra K. Moser is a professor, the Gill Endowed Chair of Nursing, and a codirector of the RICH Heart Program, University of Kentucky, College of Nursing, Lexington, Kentucky, and a professor of cardiovascular nursing, University of Ulster, Belfast, Ireland. Terry A. Lennie is a professor and a codirector of the RICH Heart Program, University of Kentucky, College of Nursing. Michele M. Pelter is an assistant professor and Kathleen Dracup is a professor emeritus, University of California San Francisco, School of Nursing, San Francisco, California. Thomas Nesbitt is a professor and associate vice chancellor for strategic technologies and alliances, and Jeffrey A. Southard is an associate clinical professor of medicine, and director of the transcatheter aortic valve replacement program, University of California, Davis, California. Search for other works by this author on: This Site PubMed Google Scholar Thomas Nesbitt, MD, MPH; Thomas Nesbitt, MD, MPH Kyoung Suk Lee is an assistant professor, Chungnam National University, College of Nursing, Dae Jeon, South Korea. Debra K. Moser is a professor, the Gill Endowed Chair of Nursing, and a codirector of the RICH Heart Program, University of Kentucky, College of Nursing, Lexington, Kentucky, and a professor of cardiovascular nursing, University of Ulster, Belfast, Ireland. Terry A. Lennie is a professor and a codirector of the RICH Heart Program, University of Kentucky, College of Nursing. Michele M. Pelter is an assistant professor and Kathleen Dracup is a professor emeritus, University of California San Francisco, School of Nursing, San Francisco, California. Thomas Nesbitt is a professor and associate vice chancellor for strategic technologies and alliances, and Jeffrey A. Southard is an associate clinical professor of medicine, and director of the transcatheter aortic valve replacement program, University of California, Davis, California. Search for other works by this author on: This Site PubMed Google Scholar Jeffrey A. Southard, MD; Jeffrey A. Southard, MD Kyoung Suk Lee is an assistant professor, Chungnam National University, College of Nursing, Dae Jeon, South Korea. Debra K. Moser is a professor, the Gill Endowed Chair of Nursing, and a codirector of the RICH Heart Program, University of Kentucky, College of Nursing, Lexington, Kentucky, and a professor of cardiovascular nursing, University of Ulster, Belfast, Ireland. Terry A. Lennie is a professor and a codirector of the RICH Heart Program, University of Kentucky, College of Nursing. Michele M. Pelter is an assistant professor and Kathleen Dracup is a professor emeritus, University of California San Francisco, School of Nursing, San Francisco, California. Thomas Nesbitt is a professor and associate vice chancellor for strategic technologies and alliances, and Jeffrey A. Southard is an associate clinical professor of medicine, and director of the transcatheter aortic valve replacement program, University of California, Davis, California. Search for other works by this author on: This Site PubMed Google Scholar Kathleen Dracup, RN, PhD Kathleen Dracup, RN, PhD Kyoung Suk Lee is an assistant professor, Chungnam National University, College of Nursing, Dae Jeon, South Korea. Debra K. Moser is a professor, the Gill Endowed Chair of Nursing, and a codirector of the RICH Heart Program, University of Kentucky, College of Nursing, Lexington, Kentucky, and a professor of cardiovascular nursing, University of Ulster, Belfast, Ireland. Terry A. Lennie is a professor and a codirector of the RICH Heart Program, University of Kentucky, College of Nursing. Michele M. Pelter is an assistant professor and Kathleen Dracup is a professor emeritus, University of California San Francisco, School of Nursing, San Francisco, California. Thomas Nesbitt is a professor and associate vice chancellor for strategic technologies and alliances, and Jeffrey A. Southard is an associate clinical professor of medicine, and director of the transcatheter aortic valve replacement program, University of California, Davis, California. Search for other works by this author on: This Site PubMed Google Scholar Am J Crit Care (2017) 26 (2): 140–148. https://doi.org/10.4037/ajcc2017634 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Share Icon Share Facebook Twitter LinkedIn Email Tools Icon Tools Cite Icon Cite Get Permissions Citation Kyoung Suk Lee, Debra K. Moser, Terry A. Lennie, Michele M. Pelter, Thomas Nesbitt, Jeffrey A. Southard, Kathleen Dracup; Obesity Paradox: Comparison of Heart Failure Patients With and Without Comorbid Diabetes. Am J Crit Care 1 March 2017; 26 (2): 140–148. doi: https://doi.org/10.4037/ajcc2017634 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search nav search search input Search input auto suggest search filter All ContentAmerican Journal of Critical Care Search Advanced Search BackgroundDiabetes is a common comorbid condition in patients with heart failure and is strongly associated with poor outcomes. Patients with heart failure who have diabetes are more likely to be obese than are those without diabetes. Obesity is positively associated with survival in patients with heart failure, but how comorbid diabetes influences the relationship between obesity and favorable prognosis is unclear.ObjectiveTo explore whether the relationship between body mass index and survival differs between patients with heart failure who do or do not have diabetes.MethodsThe sample consisted of 560 ambulatory patients with heart failure (mean age, 66 years; mean body mass index, 32; diabetes, 41%). The association between body mass index and all-cause mortality was examined by using multivariate Cox proportional hazards regression after adjustments for covariates.ResultsIn patients without diabetes, higher body mass index was associated with a lower risk for all-cause mortality after adjustments for covariates (hazard ratio, 0.952; 95% CI, 0.909–0.998). In patients with diabetes, body mass index was not predictive of all-cause death after adjustments for covariates.ConclusionObesity was a survival benefit in heart failure patients without comorbid diabetes but not in those with comorbid diabetes. The mechanisms underlying the difference in the relationship between obesity and survival due to the presence of diabetes in patients with heart failure need to be elucidated. ©2017 American Association of Critical-Care Nurses2017 You do not currently have access to this content.