New study re-examines the 'obesity paradox' in chronic heart failure patients Heart HeartFailure Obesity Cardiovascular Medicine BMI ESC_Journals escardio uniGoettingen
Study: Revisiting the obesity paradox in heart failure: what is the best anthropometric index to gauge obesity? Image Credit: Honigjp31 / Shutterstock
Since the human body is made up of muscle, fat, and bone and accumulates fat as visceral, subcutaneous, or ectopic fat, people with more fat, e.g., a Japanese sumo wrestler, or more muscle, e.g., an American wrestler with the same BMI might not be at a comparable risk of cardiovascular disease . Similarly, age-related, involuntary loss of skeletal muscle mass, as in sarcopenia, and accumulation of more intramuscular and visceral fat show a negative correlation with survival in HF patients.
Results The National Institute for Health and Care Excellence in the United Kingdom highlighted WHtR as a good predictor for the development of CVD, with a more accurate estimate of central adiposity than BMI, across patients of all ethnicities and with gender-related differences. Conversely, waist circumference and waist-to-hip ratio require more assessment because they accurately reflect central obesity but not skeletal muscle mass.
The possible explanation for the observed differences is that the WHtR reflects pathophysiological processes, e.g., body fat distribution, more precisely because waist circumference indicates central obesity. On the other hand, BMI accounts for both height and body weight. The former varies with ethnicity, gender, and skeletal weight, whereas pathological conditions, such as edema, influence body weight quite strongly.
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