Relationship Between Overweight and Obesity With Hospitalization for Heart Failure in 20,985 Patients With Type 1 Diabetes: A population-based study from the Swedish National Diabetes Registry
Artikel i vetenskaplig tidskrift, 2013
OBJECTIVETo investigate the potential relationship between overweight, obesity, and severe obesity and the risk of hospitalization for heart failure (HF) in patients with type 1 diabetes.RESEARCH DESIGN AND METHODSWe studied patients with type 1 diabetes included in the Swedish National Diabetes Register during 1998-2003, and they were followed-up until hospitalization for HF, death, or 31 December 2009. Cox regression was used to estimate relative risks.RESULTSIn a sample of 20,985 type 1 diabetic patients (mean age, 38.6 years; mean BMI, 25.0 kg/m2), 635 patients were hospitalized with HF as a primary or secondary diagnosis during a median follow-up of 9.1 years. Cox regression adjusting for age, sex, diabetes duration, smoking, HbA1c, systolic and diastolic blood pressures, and baseline and intercurrent comorbidities (including myocardial infarction) showed a significant relationship between BMI and hospitalization for HF (P < 0.0001). In reference to patients in the BMI 20-25 kg/m2 category, hazard ratios (HRs) were as follows: HR 1.22 (95% CI, 0.83-1.78) for BMI <20 kg/m2; HR 0.94 (95% CI 0.78-1.12) for BMI 25-30 kg/m2; HR 1.55 (95% CI, 1.20-1.99) for BMI 30-35 kg/m2; and HR 2.90 (95% CI, 1.92-4.37) for BMI >/=35 kg/m2.CONCLUSIONSObesity, particularly severe obesity, is strongly associated with hospitalization for HF in patients with type 1 diabetes, whereas no similar relation was present in overweight and low body weight.