Association of surrogate adiposity markers with prevalence, all-cause mortality and long-term survival of heart failure: a retrospective study from NHANES database

IntroductionObesity, especially abdominal obesity, is more common in patients with heart failure (HF), but body mass index (BMI) cannot accurately describe fat distribution. Several surrogate adiposity markers are available to reflect fat distribution and quantity. The objective of this study was to...

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Main Authors: Fan-Shun Guo, Chen Guo, Jia-Hao Dou, Jun-Xiang Wang, Rui-Yun Wu, Shou-Fang Song, Xue-Lu Sun, Yi-Wei Hu, Jin Wei
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2025.1430277/full
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author Fan-Shun Guo
Fan-Shun Guo
Chen Guo
Chen Guo
Jia-Hao Dou
Jia-Hao Dou
Jun-Xiang Wang
Rui-Yun Wu
Rui-Yun Wu
Shou-Fang Song
Shou-Fang Song
Xue-Lu Sun
Xue-Lu Sun
Yi-Wei Hu
Yi-Wei Hu
Jin Wei
Jin Wei
author_facet Fan-Shun Guo
Fan-Shun Guo
Chen Guo
Chen Guo
Jia-Hao Dou
Jia-Hao Dou
Jun-Xiang Wang
Rui-Yun Wu
Rui-Yun Wu
Shou-Fang Song
Shou-Fang Song
Xue-Lu Sun
Xue-Lu Sun
Yi-Wei Hu
Yi-Wei Hu
Jin Wei
Jin Wei
author_sort Fan-Shun Guo
collection DOAJ
description IntroductionObesity, especially abdominal obesity, is more common in patients with heart failure (HF), but body mass index (BMI) cannot accurately describe fat distribution. Several surrogate adiposity markers are available to reflect fat distribution and quantity. The objective of this study was to explore which adiposity marker is most highly correlated with HF prevalence, all-cause mortality and patients’ long-term survival.MethodsThe National Health and Nutrition Examination Survey (NHANES) database provided all the data for this study. Logistic regression analyses were adopted to compare the association of each surrogate adiposity marker with the prevalence of HF. Cox proportional hazards models and restricted cubic spline (RCS) analysis were employed to assess the association between surrogate adiposity markers and all-cause mortality in HF patients. The ability of surrogate adiposity markers to predict long-term survival in HF patients was assessed using time-dependent receiver operating characteristic (ROC) curves.Results46,257 participants (1,366 HF patients) were encompassed in this retrospective study. An area under the receiver operating characteristic curve (AUC) for the prevalence of HF assessed by weight-adjusted-waist index (WWI) was 0.70 (95% CI: 0.69-0.72). During a median follow-up of 70 months, 700 of 1366 HF patients’ death were recorded. The hazard ratio (HR) for HF patients’ all-cause mortality was 1.33 (95% CI: 1.06-1.66) in the a body shape index (ABSI) quartile 4 group and 1.43 (95% CI: 1.13-1.82) in the WWI quartile 4 group, compared with the lowest quartile group. The AUC for predicting 5-year survival of HF patients using the ABSI was 0.647 (95% CI: 0.61-0.68).ConclusionsWWI is strongly correlated with the prevalence of HF. In HF patients, those with higher WWI and ABSI tend to higher all-cause mortality. ABSI can predict patients’ long-term survival. We recommend the use of WWI and ABSI for assessing obesity in HF patients.
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spelling doaj-art-22ea6591fd4d4d7cadbb01f24261293a2025-08-20T03:16:29ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-03-011610.3389/fendo.2025.14302771430277Association of surrogate adiposity markers with prevalence, all-cause mortality and long-term survival of heart failure: a retrospective study from NHANES databaseFan-Shun Guo0Fan-Shun Guo1Chen Guo2Chen Guo3Jia-Hao Dou4Jia-Hao Dou5Jun-Xiang Wang6Rui-Yun Wu7Rui-Yun Wu8Shou-Fang Song9Shou-Fang Song10Xue-Lu Sun11Xue-Lu Sun12Yi-Wei Hu13Yi-Wei Hu14Jin Wei15Jin Wei16Department of Cardiology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, ChinaClinical Research Center for Endemic Disease of Shaanxi Province, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, ChinaDepartment of Cardiology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, ChinaClinical Research Center for Endemic Disease of Shaanxi Province, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, ChinaDepartment of Cardiology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, ChinaClinical Research Center for Endemic Disease of Shaanxi Province, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, ChinaMedicine Department of Xi’an Jiaotong University, Xi’an, Shaanxi, ChinaDepartment of Cardiology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, ChinaClinical Research Center for Endemic Disease of Shaanxi Province, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, ChinaDepartment of Cardiology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, ChinaClinical Research Center for Endemic Disease of Shaanxi Province, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, ChinaDepartment of Cardiology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, ChinaClinical Research Center for Endemic Disease of Shaanxi Province, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, ChinaDepartment of Cardiology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, ChinaClinical Research Center for Endemic Disease of Shaanxi Province, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, ChinaDepartment of Cardiology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, ChinaClinical Research Center for Endemic Disease of Shaanxi Province, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, ChinaIntroductionObesity, especially abdominal obesity, is more common in patients with heart failure (HF), but body mass index (BMI) cannot accurately describe fat distribution. Several surrogate adiposity markers are available to reflect fat distribution and quantity. The objective of this study was to explore which adiposity marker is most highly correlated with HF prevalence, all-cause mortality and patients’ long-term survival.MethodsThe National Health and Nutrition Examination Survey (NHANES) database provided all the data for this study. Logistic regression analyses were adopted to compare the association of each surrogate adiposity marker with the prevalence of HF. Cox proportional hazards models and restricted cubic spline (RCS) analysis were employed to assess the association between surrogate adiposity markers and all-cause mortality in HF patients. The ability of surrogate adiposity markers to predict long-term survival in HF patients was assessed using time-dependent receiver operating characteristic (ROC) curves.Results46,257 participants (1,366 HF patients) were encompassed in this retrospective study. An area under the receiver operating characteristic curve (AUC) for the prevalence of HF assessed by weight-adjusted-waist index (WWI) was 0.70 (95% CI: 0.69-0.72). During a median follow-up of 70 months, 700 of 1366 HF patients’ death were recorded. The hazard ratio (HR) for HF patients’ all-cause mortality was 1.33 (95% CI: 1.06-1.66) in the a body shape index (ABSI) quartile 4 group and 1.43 (95% CI: 1.13-1.82) in the WWI quartile 4 group, compared with the lowest quartile group. The AUC for predicting 5-year survival of HF patients using the ABSI was 0.647 (95% CI: 0.61-0.68).ConclusionsWWI is strongly correlated with the prevalence of HF. In HF patients, those with higher WWI and ABSI tend to higher all-cause mortality. ABSI can predict patients’ long-term survival. We recommend the use of WWI and ABSI for assessing obesity in HF patients.https://www.frontiersin.org/articles/10.3389/fendo.2025.1430277/fullsurrogate adiposity markersheart failureabdominal obesityNHANESretrospective study
spellingShingle Fan-Shun Guo
Fan-Shun Guo
Chen Guo
Chen Guo
Jia-Hao Dou
Jia-Hao Dou
Jun-Xiang Wang
Rui-Yun Wu
Rui-Yun Wu
Shou-Fang Song
Shou-Fang Song
Xue-Lu Sun
Xue-Lu Sun
Yi-Wei Hu
Yi-Wei Hu
Jin Wei
Jin Wei
Association of surrogate adiposity markers with prevalence, all-cause mortality and long-term survival of heart failure: a retrospective study from NHANES database
Frontiers in Endocrinology
surrogate adiposity markers
heart failure
abdominal obesity
NHANES
retrospective study
title Association of surrogate adiposity markers with prevalence, all-cause mortality and long-term survival of heart failure: a retrospective study from NHANES database
title_full Association of surrogate adiposity markers with prevalence, all-cause mortality and long-term survival of heart failure: a retrospective study from NHANES database
title_fullStr Association of surrogate adiposity markers with prevalence, all-cause mortality and long-term survival of heart failure: a retrospective study from NHANES database
title_full_unstemmed Association of surrogate adiposity markers with prevalence, all-cause mortality and long-term survival of heart failure: a retrospective study from NHANES database
title_short Association of surrogate adiposity markers with prevalence, all-cause mortality and long-term survival of heart failure: a retrospective study from NHANES database
title_sort association of surrogate adiposity markers with prevalence all cause mortality and long term survival of heart failure a retrospective study from nhanes database
topic surrogate adiposity markers
heart failure
abdominal obesity
NHANES
retrospective study
url https://www.frontiersin.org/articles/10.3389/fendo.2025.1430277/full
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