Key result
High bodyweight variability was associated with a 16% increased risk of incident atrial fibrillation (HR 1.16) compared to lower variability in patients with type 2 diabetes.
Why the study?
Bodyweight variability is a risk factor for AF, but its relationship with incident AF in patients with type 2 DM—and potential modification by baseline BMI, weight change, or advanced diabetic stage—remained to be clarified.
Does high bodyweight variability increase the risk of incident atrial fibrillation in patients with type 2 diabetes mellitus?
Cohort (n=670,797)
Does high bodyweight variability increase the risk of incident atrial fibrillation in patients with type 2 diabetes mellitus?
Hazard Ratio: 1.16 (95% CI 1.12–1.2)
High bodyweight variability is independently associated with an increased risk of developing atrial fibrillation in patients with type 2 diabetes, particularly in underweight individuals and those with advanced diabetes.
Bodyweight variability may identify high-risk T2D patients for AF; leaves open whether stabilization reduces incidence.
BACKGROUND: Bodyweight variability is a risk factor for atrial fibrillation (AF). We aimed to examine the relationship between bodyweight variability and the risk of AF in patients with type 2 diabetes mellitus (DM), and whether this relationship was affected by baseline body mass index (BMI), weight change, or advanced diabetic stage. METHODS: A nationwide population-based cohort of 670,797 patients with type 2 DM from the Korean National Health Insurance Service database without a history of AF and with ≥ 3 measurements of bodyweight over a 5-year period were followed up for AF development. Intra-individual bodyweight variability was calculated using variability independent of mean, and high bodyweight variability was defined as the quintile with the highest variability with the lower four quintiles as reference. RESULTS: During a median of 7.0 years of follow-up, 22,019 patients (3.3%) newly developed AF. After multivariate adjustment, those in the highest quintile of bodyweight variability showed a higher risk of incident AF (HR 1.16, 95% CI 1.12-1.20) compared to those in the lower 4 quintiles with reference bodyweight variability, irrespective of baseline BMI group and direction of overall weight change. This association was greater in magnitude in subjects with lower BMI, those on insulin, and those with a DM duration of greater than 5 years. In sensitivity analyses, high bodyweight variability was consistently associated with AF development using other indices of variability and adjusting for glycemic variability. CONCLUSIONS: High variability in bodyweight was associated with AF development, independently of traditional cardiovascular risk factors and baseline BMI. This association was stronger in underweight patients and with advanced diabetic stage. Weight fluctuation may interfere with the beneficial effects of weight loss and should be avoided when possible in weight control regimens for DM patients.
No takes yet. Share an insight, caveat, or question.
Lee et al. (2020) conducted a cohort in Type 2 diabetes mellitus (n=670,797). High bodyweight variability vs. Reference bodyweight variability (lower 4 quintiles) was evaluated on Newly-diagnosed nonvalvular atrial fibrillation (HR 1.16, 95% CI 1.12-1.20). High bodyweight variability was associated with a 16% increased risk of incident atrial fibrillation (HR 1.16) compared to lower variability in patients with type 2 diabetes.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: