Nabrdalik, Katarzyna 
ORCID: 0000-0002-0777-8048, Bisson, Arnaud, Irlik, Krzysztof, Fauchier, Gregoire, Ducluzeau, Pierre Henri, Lip, Gregory YH ORCID: 0000-0002-7566-1626 and Fauchier, Laurent
(2023)
Metabolically 'extremely unhealthy' obese and non-obese patients with diabetes and the risk of cardiovascular events: a French nationwide cohort study.
Clinical research in cardiology : official journal of the German Cardiac Society.
pp. 1-10.
Abstract
<h4>Background</h4>Non-obese patients with diabetes mellitus (DM) are becoming more prevalent, but their cardiovascular risk (CV) especially when accompanied with cardio-renal-metabolic co-morbidities (hypertension, chronic kidney disease, hyperlipidemia) is not well characterised. The aim of the study was to assess the CV risk among patients with DM in relation to obesity and cardio-renal-metabolic co-morbidities.<h4>Materials and methods</h4>This was a cohort study of all patients with DM without a history of major adverse cardiovascular event who were hospitalized for any reason in France in 2013 with at least 5 years of follow-up. They were categorized by the presence of obesity vs no obesity, as well as three cardio-renal-metabolic co-morbidities: hypertension, chronic kidney disease, hyperlipidemia. 'Extremely unhealthy' patients with DM were defined as those having all 3 co-morbidities.<h4>Results</h4>There were 196,112 patients (mean age 65.7 (SD 13.7) years; 54.3% males) included into the analysis. During a mean follow-up of 4.69 ± 1.79 years, when adjusted for multiple covariates, the non-obese and 'extremely unhealthy' obese patients had the highest risk of CV death [aHR 1.40 (95% CI, 1.22-1.61) and 1.48 (95% CI, 1.25-1.75), respectively]. The 'extremely unhealthy' obese had the highest risk of MACE-HF [aHR 1.84 (95% CI, 1.72-1.97)] and new-onset AF [aHR 1.64 (95% CI, 1.47-1.83)].<h4>Conclusion</h4>Both non-obese and obese patients with DM with associated cardio-renal-metabolic co-morbidities are an 'extremely unhealthy' phenotype with the highest risk of CV death and CV events.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Cardiovascular events, Diabetes, Extremely unhealthy, Non-obese |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 19 Dec 2023 14:54 |
| Last Modified: | 17 Mar 2024 19:05 |
| DOI: | 10.1007/s00392-023-02344-8 |
| Open Access URL: | https://doi.org/10.1007/s00392-023-02344-8 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3177535 |
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