Association Between Weight Change and the Risk of Atrial Fibrillation: Results from the Kailuan Cohort Study in China

Background: The long-term effects of sustained weight gain and loss on atrial fibrillation (AF) risk remain unclear. Herein, we examined associations between long-term weight change and incident AF. Methods: We analyzed 64,119 AF-free participants from the Kailuan cohort whose height and weight were measured in 2006–2007 and 2010–2011. Weight change was assessed as changes in body mass index (BMI), body weight, and percentage weight changes. Incident AF was ascertained according to International Classification of Diseases codes and biennial electrocardiograms. Multivariable Cox models estimated hazard ratios (HRs) and 95% confidence intervals (CIs). Results: Over a median 10.0 years’ follow-up, 583 participants developed AF. Compared with stable BMI (−3 to 3 kg/m 2 ), BMI loss ≥3 kg/m 2 was associated with diminished AF risk (HR 0.61, 95% CI 0.41–0.91), whereas BMI gain ≥3 kg/m 2 was associated with elevated risk (HR 1.41, 95% CI 1.01–1.97). Similarly, weight loss ≥10 kg was associated with diminished AF risk (HR 0.54, 95% CI 0.31–0.92), whereas weight gain ≥10 kg was associated with elevated AF risk (HR 1.66, 95% CI 1.12–2.36). The findings were consistent across percentage-change definitions. Conclusions: Long-term weight gain was associated with elevated incident AF risk, whereas sustained weight loss was associated with diminished risk, thus supporting the importance of long-term weight management for AF prevention.