Body composition and risk of incident heart failure in 1 million adults: a systematic review and dose-response meta-analysis of prospective cohort studies
Body composition and risk of incident heart failure in 1 million adults: a systematic review and dose-response meta-analysis of prospective cohort studies
Background The aim of this systematic review was to quantify the associations between body composition measures and risk of incident heart failure (HF) and its subtypes in the general population. Methods and Results We searched Medline, Embase, and Global Health databases from each database inception to January 19, 2023 for prospective studies reporting on body composition and HF risk. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The Newcastle-Ottawa scale was used to assess the risk of bias of included studies. Fixed-effects models were used for meta-analysis. Thirty-five studies were included (n
total=1 137 044; n
cases=34 422). Summary relative risk (RR) per 5-kg/m
2 higher body mass index was 1.42 (95% CI, 1.40-1.42; d701;
2=0.02,
I
2=94.4%), 1.28 (95% CI, 1.26-1.31; d701;
2=0.01,
I
2=75.8%) per 10-cm higher waist circumference, and 1.33 (95% CI, 1.28-1.37; d701;
2=0.04,
I
2=94.9%) per 0.1-unit higher waist-hip ratio. Pooled estimates of the few studies that reported on regional fat suggested significant positive association between HF risk and both visceral fat (RR, 1.08 [95% CI, 1.04-1.12]) and pericardial fat (RR, 1.08 [95% CI, 1.06-1.10]). Among HF subtypes, associations were stronger for HF with preserved ejection fraction than HF with reduced ejection fraction. No study reported on lean mass. Conclusions Pooled data suggested strong associations between adiposity and HF. The association with adiposity is stronger for HF with preserved ejection fraction than HF with reduced ejection fraction, indicating that different mechanisms may be at play in etiopathogenesis of HF subtypes. Future studies are needed to investigate role of regional fat mass and lean mass in HF risk. Registration Information REGISTRATION: URL: www.crd.york.ac.uk/prospero/. Unique identifier: CRD42020224584.
adiposity, body composition, body mass index, heart failure, systematic review
Oguntade, Ayodipupo S.
c503fa3a-f831-4af3-8cae-8cc71e568487
Islam, Nazrul
e5345196-7479-438f-b4f6-c372d2135586
Malouf, Reem
118cbe5e-a677-466b-905e-453228bc20b6
Taylor, Hannah
e63b0fae-eb6e-4e4b-bc07-9e5054e0a33c
Jin, Danyao
3b4bb056-3dc1-4729-80ce-602181221e28
Lewington, Sarah
b47fcba0-25ce-481a-81c6-5b30ea95ae34
Lacey, Ben
38227149-1faa-42d3-bf28-a9345d0c0872
22 June 2023
Oguntade, Ayodipupo S.
c503fa3a-f831-4af3-8cae-8cc71e568487
Islam, Nazrul
e5345196-7479-438f-b4f6-c372d2135586
Malouf, Reem
118cbe5e-a677-466b-905e-453228bc20b6
Taylor, Hannah
e63b0fae-eb6e-4e4b-bc07-9e5054e0a33c
Jin, Danyao
3b4bb056-3dc1-4729-80ce-602181221e28
Lewington, Sarah
b47fcba0-25ce-481a-81c6-5b30ea95ae34
Lacey, Ben
38227149-1faa-42d3-bf28-a9345d0c0872
Oguntade, Ayodipupo S., Islam, Nazrul, Malouf, Reem, Taylor, Hannah, Jin, Danyao, Lewington, Sarah and Lacey, Ben
(2023)
Body composition and risk of incident heart failure in 1 million adults: a systematic review and dose-response meta-analysis of prospective cohort studies.
Journal of the American Heart Association, 12 (13), [e029062].
(doi:10.1161/JAHA.122.029062).
Abstract
Background The aim of this systematic review was to quantify the associations between body composition measures and risk of incident heart failure (HF) and its subtypes in the general population. Methods and Results We searched Medline, Embase, and Global Health databases from each database inception to January 19, 2023 for prospective studies reporting on body composition and HF risk. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The Newcastle-Ottawa scale was used to assess the risk of bias of included studies. Fixed-effects models were used for meta-analysis. Thirty-five studies were included (n
total=1 137 044; n
cases=34 422). Summary relative risk (RR) per 5-kg/m
2 higher body mass index was 1.42 (95% CI, 1.40-1.42; d701;
2=0.02,
I
2=94.4%), 1.28 (95% CI, 1.26-1.31; d701;
2=0.01,
I
2=75.8%) per 10-cm higher waist circumference, and 1.33 (95% CI, 1.28-1.37; d701;
2=0.04,
I
2=94.9%) per 0.1-unit higher waist-hip ratio. Pooled estimates of the few studies that reported on regional fat suggested significant positive association between HF risk and both visceral fat (RR, 1.08 [95% CI, 1.04-1.12]) and pericardial fat (RR, 1.08 [95% CI, 1.06-1.10]). Among HF subtypes, associations were stronger for HF with preserved ejection fraction than HF with reduced ejection fraction. No study reported on lean mass. Conclusions Pooled data suggested strong associations between adiposity and HF. The association with adiposity is stronger for HF with preserved ejection fraction than HF with reduced ejection fraction, indicating that different mechanisms may be at play in etiopathogenesis of HF subtypes. Future studies are needed to investigate role of regional fat mass and lean mass in HF risk. Registration Information REGISTRATION: URL: www.crd.york.ac.uk/prospero/. Unique identifier: CRD42020224584.
Text
JAHA.122.029062
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More information
Accepted/In Press date: 15 May 2023
e-pub ahead of print date: 22 June 2023
Published date: 22 June 2023
Additional Information:
Funding Information:
This work was funded by a doctoral scholarship to A.S.O. from the Nuffield Department of Population Health, University of Oxford (Oxford, United Kingdom). B.L. acknowledges support from UK Biobank, funded largely by the UK Medical Research Council and Wellcome.
Funding Information:
S.L. reports grants from the Medical Research Council and research funding from the US Centers for Disease Control and Prevention Foundation (with support from Amgen) during the conduct of the study. N.I. reports grants from the Canadian Institutes of Health Research, Office for National Statistics, National Institute for Health and Care Research, and Health Data Research UK unrelated to this study. The remaining authors have no disclosures to report.
Publisher Copyright:
© 2023 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
Keywords:
adiposity, body composition, body mass index, heart failure, systematic review
Identifiers
Local EPrints ID: 478522
URI: http://eprints.soton.ac.uk/id/eprint/478522
PURE UUID: 468a09a3-29a2-4e47-8b68-c5cb821c6e6e
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Date deposited: 04 Jul 2023 17:44
Last modified: 17 Mar 2024 04:15
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Contributors
Author:
Ayodipupo S. Oguntade
Author:
Nazrul Islam
Author:
Reem Malouf
Author:
Hannah Taylor
Author:
Danyao Jin
Author:
Sarah Lewington
Author:
Ben Lacey
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