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October 13, 2022Cardiovascular DiabetologyOpen Access

Association between metabolically healthy obesity and risk of atrial fibrillation: taking physical activity into consideration

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Key result

Metabolically healthy obesity was significantly associated with a 35% reduced risk of incident atrial fibrillation compared with metabolically unhealthy obesity (HR 0.65).

Why the study?

The modification of physical activity on metabolic status in relation to atrial fibrillation risk in obesity remains unknown.

Does metabolically healthy obesity and physical activity reduce the risk of atrial fibrillation in obese populations compared to metabolically unhealthy obesity?

Population

119,424 obese participants from UK Biobank

Comparison

MHO vs MUO and levels of physical activity

Design

Cohort study using Cox proportional hazards models

Authors

RWRuoting WangIOIván OlierSOSandra Ortega‐Martorell

Discussion

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Overview

Metabolically healthy obesity was associated with lower AF risk than unhealthy obesity; leaves open whether modifying metabolic status reduces incidence.

Study Design

Type

Cohort (n=119,424)

Multicenter

Yes

Structured PICO

Does metabolically healthy obesity and physical activity reduce the risk of atrial fibrillation in obese populations compared to metabolically unhealthy obesity?

P
Population
119,424 obese adults free of baseline atrial fibrillation from the UK Biobank, followed for a median of 8.1 years to assess the risk of incident atrial fibrillation based on metabolic status and physical activity.
E
Exposure
Metabolically healthy obesity (MHO) and varying levels of moderate-to-vigorous physical activity (MVPA)
C
Comparator
Metabolically unhealthy obesity (MUO) and no MVPA
O
Outcome
Risk of atrial fibrillation (AF)hard clinical

Main Result

Hazard Ratio: 0.65 (95% CI 0.57–0.73)

p-value: p=<0.01

Metabolically healthy obesity is associated with a lower risk of atrial fibrillation than metabolically unhealthy obesity, and moderate-to-vigorous physical activity further reduces this risk in metabolically unhealthy individuals.

Limitations

  • AF diagnosed by trained physicians from different hospitals may lead to misdiagnosis
  • Possible bias or residual confounding effects inherent to an observational study design
  • No data on left atrial remodeling and function available for analysis
  • Physical activity information collected by self-report questionnaire, possibly incurring information bias and overestimation
  • Low response rate at baseline (5.5%) may compromise the generalizability of the findings
  • Severity of MUO assessed only based on the number of metabolic disorders, regardless of disease severity and management

Cite This Study

Wang et al. (2022) conducted a cohort in Obesity and Atrial Fibrillation (n=119,424). Metabolically healthy obesity (MHO) vs. Metabolically unhealthy obesity (MUO) was evaluated on Incident atrial fibrillation (HR 0.65, 95% CI 0.57-0.73, p=<0.01). Metabolically healthy obesity was significantly associated with a 35% reduced risk of incident atrial fibrillation compared with metabolically unhealthy obesity (HR 0.65).

synapsesocial.com/papers/6a6307df47366de40a286cf2https://doi.org/10.1186/s12933-022-01644-z
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