| Purpose: To evaluate the effect of body mass index(BMI)on the prognosis of patients with chronic heart failure(CHF)and type 2 diabetes(T2DM),and to explore the existence of the obesity paradox.Methods: A total of 226 patients with CHF and T2 DM in our hospital from 2014 to 2015 were included in this retrospective study.Patients were divided into 3 groups according to their BMI: normal weight group(18.5 kg/m~2 ?BMI<24 kg/m~2),overweight group(24 kg/m~2 ?BMI<28 kg/m~2),and obese group(BMI?28 kg/m~2).Followed-up was completed from June to July,2016.Analyze the clinical parameters,the all-cause mortality and major adverse cardiovascular events(MACE,including cardiac death and rehospitalization for heart failure)among three groups.Results: A total of 226 patients were finished during follow up(92 in normal weight group,93 in overweight group and 41 in obesity group).There were 28 cases(12.4%)all-cause deaths and 101 cases(44.7%)MACE.Incidence of all-cause mortality in normal weight group 14.1%(13/92)and in the obese group 12.2%(5/41),was higher than in overweight group 10.8%(10/93),(P=0.784).Incidence of MACE in normal weight group 50%(46/92)and in the obese group 58.5%(24/41),was higher than in overweight group 33.3%(32/93),(P<0.05).Kaplan-Meier curves showed the incidence of MACE were lower in overweight group than in the other two groups(P<0.01).There was no differences in the all-cause mortality among three groups(P=0.824).Multivariate Cox regression model showed normal weight patients had decreased risk for MACE(RR=0.605,95%CI,0.363-1.008 P=0.054)compared with patients of obesity group.overweight patients had more obvious decreased risk for MACE(RR=0.430,95%CI,0.251-0.738,P<0.01).Conclusions: The obesity paradox may absence in patients with CHF and T2 DM.To control BMI under 28kg/m~2 may help reduce the incidence of MACE. |
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