PLoS Medicine (Jun 2021)

Associations of obesity and malnutrition with cardiac remodeling and cardiovascular outcomes in Asian adults: A cohort study.

  • Shih-Chieh Chien,
  • Chanchal Chandramouli,
  • Chi-In Lo,
  • Chao-Feng Lin,
  • Kuo-Tzu Sung,
  • Wen-Hung Huang,
  • Yau-Huei Lai,
  • Chun-Ho Yun,
  • Cheng-Huang Su,
  • Hung-I Yeh,
  • Ta-Chuan Hung,
  • Chung-Lieh Hung,
  • Carolyn S P Lam

DOI
https://doi.org/10.1371/journal.pmed.1003661
Journal volume & issue
Vol. 18, no. 6
p. e1003661

Abstract

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BackgroundObesity, a known risk factor for cardiovascular disease and heart failure (HF), is associated with adverse cardiac remodeling in the general population. Little is known about how nutritional status modifies the relationship between obesity and outcomes. We aimed to investigate the association of obesity and nutritional status with clinical characteristics, echocardiographic changes, and clinical outcomes in the general community.Methods and findingsWe examined 5,300 consecutive asymptomatic Asian participants who were prospectively recruited in a cardiovascular health screening program (mean age 49.6 ± 11.4 years, 64.8% male) between June 2009 to December 2012. Clinical and echocardiographic characteristics were described in participants, stratified by combined subgroups of obesity and nutritional status. Obesity was indexed by body mass index (BMI) (low, ≤25 kg/m2 [lean]; high, >25 kg/m2 [obese]) (WHO-recommended Asian cutoffs). Nutritional status was defined primarily by serum albumin (SA) concentration (low, ConclusionsIn our cohort study among asymptomatic community-based adults in Taiwan, we found that obese individuals with poor nutritional status have the highest comorbidity burden, the most adverse cardiac remodeling, and the least favorable composite outcome.