Relationship Between Overweight and Obesity With Hospitalization for Heart Failure in 20,985 Patients With Type 1 Diabetes

Abstract

OBJECTIVE To 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 METHODS We studied patients with type 1 diabetes included in the Swedish National Diabetes Registry 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. RESULTS In 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. CONCLUSIONS Obesity, 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.