Is there an obesity paradox in pulmonary arterial hypertension?
Bibliographic record
Abstract
Background: Despite the deleterious health effects of obesity, an obesity paradox has been described in many diseases, including in heterogeneous populations with pulmonary hypertension. Whether obesity is associated with better outcomes in idiopathic (IPAH), drug and toxin-induced (DPAH) or heritable pulmonary arterial hypertension (HPAH) is not known. Methods: We assessed 1363 incident patients with IPAH, DPAH, and HPAH from the French Pulmonary Hypertension Registry. Cox proportional hazards regression was used to assess the effect of obesity on the risk of death or lung transplantation. Obesity was defined as body mass index (BMI)>30 kg/m2. Results: The prevalence of obesity was 30.7%. There was a higher proportion of females (66.6% vs 53.4%, p<0.01) and DPAH (30.5% vs 9.6%, p<0.01) among obese patients. Systemic hypertension, diabetes, and hypothyroidism were significantly more frequent among obese patients. Obese patients had a higher proportion in New York Heart Association class III (65.5% vs. 57.0%) but fewer were class IV (11.5% vs 16.7%)(p<0.01), and 6-minute walk distance was lower (278.3±119.6 vs. 322.3±145.3, p<0.01). Right atrial pressure, pulmonary wedge pressure and cardiac index were higher while pulmonary vascular resistance was lower in obese patients. Neither BMI (adjusted HR 0.99, 95%CI 0.97-1.01, p=0.41) nor obesity (adjusted HR 1.0, 95%CI 0.99-1.01, p=0.46) were predictive of death or transplantation in multivariate analyses. Conclusions: We found no association between obesity and survival in a large cohort of incident IPAH, DPAH and HPAH patients. Previous evidence of an obesity paradox in pulmonary hypertension may be related to other confounding factors.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.012 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".