title: Impact of body mass index on clinical outcome in patients hospitalized with congestive heart failure.
abstract: BACKGROUND
  Obesity has recently been shown to have a favorable effect on the prognosis of patients with congestive heart failure (CHF), but only a few such studies are available in Japan. The purpose of the present study was to investigate whether the obesity paradox is still present after adjusting for CHF characteristics.
  
  
  RESULTS
  A total of 219 patients hospitalized with CHF were reviewed, and the impact of body mass index (BMI) on prognosis was examined. Patients were divided into 4 groups according to BMI quartiles. The endpoint was defined as all-cause death or unplanned CHF hospitalization. According to univariate analysis, a higher BMI was associated with better outcomes. High-BMI patients were younger, likely to be male, and had a higher prevalence of hypertension and diabetes. The plasma B-type natriuretic peptide (BNP) levels and blood urea nitrogen (BUN) levels were lower, while the serum hemoglobin and sodium levels were higher in high-BMI patients. The prevalence of atrial fibrillation was lower in high-BMI patients. Predictors for all-cause death or CHF hospitalization based on univariate analysis were age, prior CHF hospitalization, estimated glomerular filtration rate, plasma BNP levels, BUN levels, and serum hemoglobin and sodium levels. According to multivariate analysis, a high BMI was still associated with better outcomes.
  
  
  CONCLUSIONS
  High BMI was associated with better clinical outcomes in Japanese CHF patients.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan. komu@jikei.ac.jp
authors.forename: Kimiaki
authors.initials: K
authors.lastname: Komukai
authors.forename: Kosuke
authors.initials: K
authors.lastname: Minai
authors.forename: Satoshi
authors.initials: S
authors.lastname: Arase
authors.forename: Takayuki
authors.initials: T
authors.lastname: Ogawa
authors.forename: Tokiko
authors.initials: T
authors.lastname: Nakane
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Nagoshi
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Kayama
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Abe
authors.forename: Satoshi
authors.initials: S
authors.lastname: Morimoto
authors.forename: Kazuo
authors.initials: K
authors.lastname: Ogawa
authors.forename: Shinya
authors.initials: S
authors.lastname: Fujii
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sekiyama
authors.forename: Taro
authors.initials: T
authors.lastname: Date
authors.forename: Makoto
authors.initials: M
authors.lastname: Kawai
authors.forename: Kenichi
authors.initials: K
authors.lastname: Hongo
authors.forename: Ikuo
authors.initials: I
authors.lastname: Taniguchi
authors.forename: Michihiro
authors.initials: M
authors.lastname: Yoshimura
mesh_terms: D000368:Aged; D001806:Blood Urea Nitrogen; D015992:Body Mass Index; D015897:Comorbidity; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007297:Inpatients; D007564:Japan; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood; D009765:Obesity / Q000097:blood / Q000150:complications* / Q000453:epidemiology*; D011379:Prognosis; D012189:Retrospective Studies; D012964:Sodium / Q000097:blood
chemical_list: D006454:Hemoglobins; D020097:Natriuretic Peptide, Brain; D012964:Sodium