title: Body mass index is closely correlated to incident diabetes in patients with heart failure or myocardial infarction.
abstract: BACKGROUND
  Diabetes in patients with heart failure or myocardial infarction (MI) increases morbidity and mortality, but little is known about the impact of obesity on the risk of developing diabetes in these populations.
  
  
  METHODS
  A cohort of patients consecutively hospitalized with heart failure (n = 3472) or MI (n = 5723) was followed in the period 1995-2006.
  
  
  METHODS
  Multivariable Cox proportional-hazard models were used to estimate the risk of developing diabetes according to the World Health Organization body mass index (BMI) classification. Normal weight patients (BMI 18.5-24.9 kg/m(2)) were used as the reference.
  
  
  RESULTS
  In both populations, more than half of the patients with a BMI above 34.9 kg/m(2) developed diabetes. In heart failure patients, a BMI above 24.9 kg/m(2) was associated with an increased risk of diabetes for the three BMI groups, i.e. 25.0-29.9 kg/m(2), 30.9-34.9 kg/m(2), and >34.9 kg/m(2), with adjusted hazard ratios (HRs) of 2.16 (95% confidence interval 1.50-3.12), 3.89 (2.61-5.78), and 6.06 (3.79-9.69), respectively. In MI patients, the adjusted HRs in the three corresponding BMI groups were 1.84 (1.44-2.37), 4.31 (3.26-5.69), and 9.50 (6.70-13.46), respectively. Incident diabetes was associated with increased cardiovascular and all-cause mortality risks with adjusted HRs of greater magnitude than in prevalent diabetes.
  
  
  CONCLUSIONS
  BMI was an independent predictor of incident diabetes in patients with either heart failure or MI. More than half of the patients with a BMI above 34.9 kg/m(2) developed diabetes during follow-up. Incident diabetes carries an increased mortality risk.
authors: Department of Cardiology, Gentofte University Hospital, Niels Andersens Vej 65, Copenhagen, Denmark. mdschmiegelow@gmail.com
authors: Michelle
authors: M
authors: Schmiegelow
authors: Charlotte
authors: C
authors: Andersson
authors: Jonas B
authors: JB
authors: Olesen
authors: Steen Z
authors: SZ
authors: Abildstrom
authors: Lars
authors: L
authors: Kober
authors: Christian
authors: C
authors: Torp-Pedersen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D016009:Chi-Square Distribution; D003718:Denmark / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006333:Heart Failure / Q000453:epidemiology* / Q000401:mortality; D006801:Humans; D015994:Incidence; D007297:Inpatients / Q000706:statistics & numerical data; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000401:mortality; D009765:Obesity / Q000453:epidemiology* / Q000401:mortality; D015995:Prevalence; D011379:Prognosis; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors