High Variability of Body Mass Index Independently Associated with Incident Heart Failure.

• Type of Material: Article
• Authors: Chang Liu, Emory University; Yiyun Chiang, Emory University; Qin Hui, Emory University; Jin J Zhou, University of California, Los Angeles; Peter Wilson, Emory University; Jacob Joseph, VA Providence Healthcare System, Providence, Rhode Island; Yan Sun, Emory University
• Language: English
• Date: 2023-03-31
• Publisher: medRxiv
• Publication Version: Preprint (Prior to Peer Review)
• Copyright Statement: The copyright holder for this preprint is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1101/2023.03.30.23287990
• Title of Journal or Parent Work: medRxiv
• Grant/Funding Information: This research is supported in part by funding from the National Institute of Health grant P01-HL154996, and Department of Veterans Affairs Office of Research and Development, Million Veteran Program grant I01-BX005831 and I01-BX004821.
• Keywords: Body Mass Index

Abstract

BACKGROUND: Heart failure (HF) is a serious condition with increasing prevalence, high morbidity, and increased mortality. Obesity is an established risk factor for cardiovascular diseases, including HF. Fluctuation in body mass index (BMI) has shown a higher risk of cardiovascular outcomes. We investigated the association between BMI variability and incident HF. METHODS: In the UK Biobank, we established a prospective cohort after excluding participants with prevalent HF or cancer at enrollment. A total of 99,368 White (British, Irish, and any other white background) participants with ≥ 3 BMI measures during > 2 years preceding enrollment were included, with a median follow-up of 12.5 years. The within-participant variability of BMI was evaluated using standardized standard deviation (SD) and coefficient of variation (CV). The association of BMI variability with incident HF was assessed using Fine and Gray's competing risk model, and adjusted for age, sex, smoking history, alcohol consumption, diabetes, hypertension, history of heart attack, stroke, atrial fibrillation, lipids, estimated glomerular filtration rate and mean BMI per individual. RESULTS: In the fully adjusted model, higher BMI variability measured in both SD and CV were significantly associated with higher risk in HF incidence (SD: Hazard Ratio [HR] 1.05, 95% Confidence Interval [CI] 1.02 - 1.07, p = 0.0002; CV: HR 1.06, 95% CI 1.04 - 1.09, p < 0.0001). CONCLUSIONS: Longitudinal health records capture BMI fluctuation, which independently predicts HF incidence. Integration of long-term BMI and other routinely measured health factors may improve risk prediction of HF and other cardiovascular outcomes.