Table 2.
Baseline characteristics according to ‘lean diabetes’ phenotype (versus non‐lean) and insulin use (versus no insulin use) in patients with diabetes
| BMI ≥25 kg/m2 | BMI <25 kg/m2 | p‐value | No insulin | Insulin | p‐value | |
|---|---|---|---|---|---|---|
| Patients, n (%) | 2118 (88.7) | 270 (11.3) | 1732 (72.5) | 656 (27.5) | ||
| Age, years, mean (± SD) | 71.8 ± 8.1 | 74.0 ± 9.2 | <0.001 | 72.7 ± 8.3 | 70.4 ± 8.1 | <0.001 |
| Women, n (%) | 1042 (49.2) | 136 (50.4) | 0.72 | 864 (49.9) | 314 (47.9) | 0.38 |
| Race, n (%) | <0.001 | <0.001 | ||||
| Asian | 211 (10.0) | 105 (38.9) | 235 (13.6) | 81 (12.3) | ||
| Black | 60 (2.8) | 1 (0.4) | 30 (1.7) | 31 (4.7) | ||
| Other | 84 (4.0) | 8 (3.0) | 64 (3.7) | 28 (4.3) | ||
| White | 1763 (83.2) | 156 (57.8) | 1403 (81.0) | 516 (78.7) | ||
| Region, n (%) | <0.001 | <0.001 | ||||
| Asia‐Pacific/other | 289 (13.6) | 109 (40.4) | 296 (17.1) | 102 (15.5) | ||
| Central Europe | 826 (39.0) | 61 (22.6) | 691 (39.9) | 196 (29.9) | ||
| Latin America | 145 (6.8) | 12 (4.4) | 113 (6.5) | 44 (6.7) | ||
| North America | 288 (13.6) | 15 (5.6) | 169 (9.8) | 134 (20.4) | ||
| Western Europe | 570 (26.9) | 73 (27.0) | 463 (26.7) | 180 (27.4) | ||
| HbA1c, %, median (Q1–Q3) | 7.0 (6.5–7.9) | 6.9 (6.5–7.7) | 0.26 | 6.7 (6.3–7.4) | 7.9 (7.1–9.2) | <0.001 |
| Non‐ischaemic aetiology, n (%) | 1272 (60.1) | 135 (50.0) | 0.002 | 1044 (60.3) | 363 (55.3) | 0.03 |
| Prior HF hospitalization, n (%) | 1112 (52.5) | 136 (50.4) | 0.50 | 860 (49.7) | 388 (59.1) | <0.001 |
| HF duration, n (%) | 0.06 | 0.12 | ||||
| 0–3 months | 315 (14.9) | 47 (17.4) | 270 (15.6) | 92 (14.1) | ||
| 3–6 months | 222 (10.5) | 36 (13.3) | 182 (10.5) | 76 (11.6) | ||
| 6–12 months | 254 (12.0) | 44 (16.3) | 230 (13.3) | 68 (10.4) | ||
| 1–2 years | 311 (14.7) | 29 (10.7) | 256 (14.8) | 84 (12.8) | ||
| 2–5 years | 475 (22.5) | 54 (20.0) | 374 (21.7) | 155 (23.7) | ||
| >5 years | 534 (25.3) | 60 (22.2) | 415 (24.0) | 179 (27.4) | ||
| NYHA class, n (%) | 0.17 | 0.048 | ||||
| I | 68 (3.2) | 11 (4.1) | 58 (3.4) | 21 (3.2) | ||
| II | 1583 (74.8) | 213 (78.9) | 1324 (76.5) | 472 (72.0) | ||
| III | 458 (21.6) | 44 (16.3) | 344 (19.9) | 158 (24.1) | ||
| IV | 8 (0.4) | 2 (0.7) | 5 (0.3) | 5 (0.8) | ||
| LVEF, %, mean (± SD) | 57.2 ± 7.9 | 57.1 ± 7.9 | 0.77 | 57.1 ± 7.9 | 57.6 ± 7.9 | 0.20 |
| Heart rate, bpm, mean (± SD) | 71.2 ± 12.1 | 72.7 ± 13.5 | 0.067 | 71.5 ± 12.3 | 71.1 ± 12.3 | 0.50 |
| SBP, mmHg, mean (± SD) | 131.8 ± 15.4 | 130.2 ± 15.6 | 0.11 | 131.1 ± 15.1 | 133.2 ± 16.3 | 0.002 |
| BMI, kg/m2, median (Q1–Q3) | 31.8 (28.6–35.3) | 23.4 (21.9–24.3) | <0.001 | 30.4 (27.3–34.2) | 32.4 (28.6–35.9) | <0.001 |
| Waist circumference, cm, median (Q1–Q3) | 109 (100–118) | 90 (84–96) | <0.001 | 105 (96–115) | 110 (100–119) | <0.001 |
| Waist‐hip ratio, mean (± SD) | 0.99 ± 0.12 | 0.93 ± 0.08 | <0.001 | 0.97 ± 0.11 | 0.99 ± 0.14 | 0.011 |
| Current smoker, n (%) | 142 (6.7) | 25 (9.4) | 0.11 | 122 (7.1) | 45 (6.9) | 0.85 |
| eGFR, ml/min/1.73 m2, mean (± SD) | 62.0 ± 19.8 | 64.0 ± 20.2 | 0.11 | 63.2 ± 19.5 | 59.6 ± 20.5 | <0.001 |
| Serum creatinine, mg/dl, mean (± SD) | 1.12 ± 0.33 | 1.07 ± 0.31 | 0.013 | 1.09 ± 0.32 | 1.18 ± 0.36 | <0.001 |
| Potassium, mmol/l, median (Q1–Q3) | 4.5 (4.2–4.8) | 4.5 (4.2–4.8) | 0.57 | 4.5 (4.2–4.8) | 4.5 (4.2–4.9) | 0.22 |
| NT‐proBNP, pg/ml, median (Q1–Q3) without AF | 572 (375–992) | 879 (483–1584) | <0.001 | 587 (382–1091) | 620 (379–1059) | 0.49 |
| NT‐proBNP, pg/ml, median (Q1–Q3) with AF | 1557 (1159–2168) | 1793 [1370–2465] | 0.009 | 1576 (1192–2204) | 1595 (1136–2178) | 0.62 |
| KCCQ‐CSS, mean (± SD) | 70.5 ± 19.2 | 76.5 ± 18.5 | <0.001 | 71.9 ± 18.8 | 69.2 ± 20.1 | 0.002 |
| Signs or symptoms, n (%) | ||||||
| Paroxysmal nocturnal dyspnoea | 99 (4.7) | 8 (3.0) | 0.20 | 74 (4.3) | 33 (5.0) | 0.42 |
| Dyspnoea at rest | 70 (3.3) | 6 (2.2) | 0.34 | 56 (3.2) | 20 (3.1) | 0.82 |
| Dyspnoea on effort | 1958 (92.6) | 241 (89.3) | 0.05 | 1598 (92.4) | 601 (91.8) | 0.62 |
| Fatigue | 1088 (51.4) | 138 (51.1) | 0.92 | 901 (52.1) | 325 (49.6) | 0.28 |
| Orthopnoea | 453 (21.4) | 38 (14.1) | 0.005 | 314 (18.2) | 177 (27.0) | <0.001 |
| Third heart sound | 55 (2.6) | 6 (2.2) | 0.75 | 51 (3.0) | 10 (1.5) | 0.048 |
| Jugular venous distention | 306 (14.6) | 29 (10.8) | 0.095 | 229 (13.3) | 106 (16.4) | 0.054 |
| Oedema | 889 (42.0) | 80 (29.6) | <0.001 | 672 (38.8) | 297 (45.3) | 0.004 |
| Rales | 157 (7.4) | 16 (5.9) | 0.37 | 127 (7.3) | 46 (7.0) | 0.79 |
| Medical history, n (%) | ||||||
| Myocardial infarction | 556 (26.3) | 81 (30.0) | 0.19 | 429 (24.8) | 208 (31.7) | <0.001 |
| Atrial flutter/fibrillation a | 690 (32.7) | 78 (28.9) | 0.20 | 615 (35.6) | 153 (23.5) | <0.001 |
| Hypertension | 2063 (97.4) | 246 (91.1) | <0.001 | 1671 (96.5) | 638 (97.3) | 0.34 |
| Stroke | 240 (11.3) | 32 (11.9) | 0.79 | 183 (10.6) | 89 (13.6) | 0.04 |
| COPD | 315 (14.9) | 35 (13.0) | 0.40 | 246 (14.2) | 104 (15.9) | 0.30 |
| Anaemia | 381 (18.0) | 46 (17.0) | 0.70 | 265 (15.3) | 162 (24.7) | <0.001 |
| Lower limb artery stenosis | 56 (2.7) | 16 (5.9) | 0.003 | 44 (2.5) | 28 (4.3) | 0.03 |
| Sleep apnoea | 215 (10.2) | 6 (2.2) | <0.001 | 130 (7.5) | 91 (14.0) | <0.001 |
| Medications, n (%) | ||||||
| Diuretics | 2044 (96.5) | 246 (91.1) | <0.001 | 1650 (95.3) | 640 (97.6) | 0.01 |
| ACE‐inhibitor/ARB | 1842 (87.0) | 227 (84.1) | 0.18 | 1506 (87.0) | 563 (85.8) | 0.47 |
| Beta‐blocker | 1757 (83.0) | 204 (75.6) | 0.003 | 1418 (81.9) | 543 (82.8) | 0.61 |
| MRA | 546 (25.8) | 75 (27.8) | 0.48 | 454 (26.2) | 167 (25.5) | 0.71 |
| Antiplatelets | 318 (15.0) | 60 (22.2) | 0.002 | 241 (13.9) | 137 (20.9) | <0.001 |
| Insulin | 591 (27.9) | 65 (24.1) | 0.18 | 0 (0.0) | 656 (100.0) | <0.001 |
| Oral hypoglycaemic agents | 1332 (62.9) | 144 (53.3) | 0.002 | 1096 (63.3) | 380 (57.9) | 0.02 |
| GLP‐1 receptor agonist | 20 (0.9) | 0 (0.0) | 0.11 | 11 (0.6) | 9 (1.4) | 0.08 |
ACE, angiotensin‐converting enzyme; AF, atrial fibrillation; ARB, angiotensin receptor blocker; BMI, body mass index; COPD, chronic obstructive pulmonary disease; eGFR, estimated glomerular filtration rate; GLP‐1, glucagon‐like peptide‐1; HF, heart failure; KCCQ‐CSS, Kansas City Cardiomyopathy Questionnaire clinical summary score; LVEF, left ventricular ejection fraction; MRA, mineralocorticoid receptor antagonist; NT‐proBNP, N‐terminal pro‐B‐type natriuretic peptide; NYHA, New York Heart Association; SBP, systolic blood pressure; SD, standard deviation.
a
On electrocardiogram at baseline.