Abstract 016: Association Of Fat Mass, Lean Mass, And Waist Circumference With Risk Of Heart Failure Among Community Dwelling Adults

Abstract

Introduction: Higher body mass index and obesity are associated with a higher risk of diabetes and heart failure (HF) development. However, the contribution of measures of body composition such as fat mass (FM), lean mass (LM), and central adiposity (waist circumference, WC) towards the risk of HF, and if these relationships are modified by diabetes status (DM) is unknown. Methods: Adults from visit 5 of the Atherosclerosis Risk in Communities Study without prevalent HF were included. FM and LM were measured using bioelectric impedance. Multivariable adjusted Cox proportional hazards models were created to evaluate the associations of FM, LM, and WC with the risk of HF after adjustment for potential confounders ( see Fig legend ). Multiplicative interaction testing and stratified analysis by DM status were performed using adjusted Cox models and restricted cubic splines to evaluate whether the association of body composition parameters and risk of HF were modified by DM status. Results: The present study included 5,555 participants (58.3% women, 79.3% white). Over a median follow-up of 4.6 years, there were 254 HF events (4.6%). In the overall cohort, higher LM was significantly associated with higher risk of HF (aHR [95% CI] per 1 SD higher LM: 1.34 [1.13-1.60]) with no interaction by DM status. However, the associations of FM and WC with risk of HF were modified by DM status (p-interaction: FM*diabetes = 0.03, WC*diabetes = 0.008). Higher FM and WC were each significantly associated with higher risk of HF in adults with DM (aHR [95% CI] per 1-SD higher FM: 1.23 [1.01-1.49], per 1SD higher WC: 1.57 [1.31 - 1.89]) but not among those without DM at baseline (aHR [95% CI] FM: 0.99 [0.80 - 1.23], WC: 1.06 [0.87 - 1.30]) ( Figure ). Conclusions: Higher LM was significantly associated with a higher risk of HF irrespective of diabetes status. In contrast, the association of FM and WC with the risk of HF was modified by the presence of DM such that higher FM and WC were associated with a higher risk of HF among adults with DM but not those without DM.