What does this research mean for the field?

Osteosarcopenia is independently associated with an increased risk of incident atrial fibrillation beyond traditional risk factors. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To investigate whether osteosarcopenia is associated with incident atrial fibrillation and evaluate its incremental prognostic value beyond established risk factors.

September 17, 2026JACC AsiaOpen Access

Osteosarcopenia as a Risk Factor for Atrial Fibrillation

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Atrial Fibrillation (n=482137). Intervention: Osteosarcopenia vs. Reference group (no sarcopenia or osteoporosis). Primary outcome: Incident atrial fibrillation (aHR 1.33, 95% CI 1.09-1.62).

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Why the study?

Does osteosarcopenia increase the risk of incident atrial fibrillation in adults without previous AF?

Population

482,137 participants without previous AF at baseline from the UK Biobank, mean age 56.4 ± 8.1 years, 45.2%…

Comparison

Osteosarcopenia vs Reference group, sarcopenia alone, and…

Design

Cohort

Follow-up

median 13.8 [13.1;14.6] years

Key result

Osteosarcopenia was independently associated with an increased risk of incident atrial fibrillation (aHR 1.33; 95% CI 1.09-1.62) compared to the reference group.

Authors

KLKyung‐Yeon Lee TRTae-Min Rhee JCJungMin Choi

Discussion

Member takes

Overview

Osteosarcopenia may flag higher AF risk for screening consideration; extends observational links to incident AF but requires prospective validation before practice change.

Key Points

To investigate whether osteosarcopenia is associated with incident atrial fibrillation and evaluate its incremental prognostic value beyond established risk factors.
Analyzed baseline data from 482,137 participants without prior atrial fibrillation in the UK Biobank (mean age 56.4 ± 8.1 years; 45.2% male) over a median follow-up of 13.8 years.
Categorized participants into four groups: reference, sarcopenia alone, osteoporosis alone, and osteosarcopenia, using multivariable Cox regression to estimate incident atrial fibrillation risk.
Performed replication analysis using data from the independent H-PEACE cohort.
In the primary UK Biobank cohort, osteosarcopenia was present in 0.65% of individuals and showed the strongest independent association with incident atrial fibrillation (aHR: 1.33; 95% CI: 1.09–1.62).
Osteoporosis alone was significantly associated with incident atrial fibrillation (aHR: 1.18; 95% CI: 1.03–1.36), whereas sarcopenia alone was not (aHR: 1.05; 95% CI: 0.99–1.10).
Replication in the H-PEACE cohort confirmed a heightened risk of atrial fibrillation among individuals with osteosarcopenia (adjusted OR: 2.10; 95% CI: 1.06–4.13; P = 0.032).

Study Design

Type

Cohort (n=482,137)

Multicenter

Yes

Structured PICO

Does osteosarcopenia increase the risk of incident atrial fibrillation in adults without previous AF?

Population

482,137 participants without previous atrial fibrillation (mean age 56.4 years, 54.8% female) followed for a median of 13.8 years.

Exposure

Osteosarcopenia (concurrent reductions in skeletal muscle mass and bone mineral density)

Comparator

Reference group (no sarcopenia or osteoporosis), sarcopenia alone, and osteoporosis alone

Outcome

Incident AFhard clinical

Main Result

Hazard Ratio: 1.33 (95% CI 1.09–1.62)

Osteosarcopenia is independently associated with an increased risk of incident atrial fibrillation, suggesting a potential role for tailored AF screening in this population.

Limitations

The improvement in risk discrimination was limited.

Cite This Study

Lee et al. (2026) conducted a cohort in Atrial Fibrillation (n=482,137). Osteosarcopenia vs. Reference group (no sarcopenia or osteoporosis) was evaluated on Incident atrial fibrillation (aHR 1.33, 95% CI 1.09-1.62). Osteosarcopenia was independently associated with an increased risk of incident atrial fibrillation (aHR 1.33; 95% CI 1.09-1.62) compared to the reference group.

synapsesocial.com/papers/6aaba4611561938ee54ba360 https://doi.org/10.1016/j.jacasi.2026.08.006

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September 17, 2026JACC AsiaOpen Access

Osteosarcopenia as a Risk Factor for Atrial Fibrillation

View Full Paper

Ask AI

Bookmark

Why the study?

Does osteosarcopenia increase the risk of incident atrial fibrillation in adults without previous AF?

Population

482,137 participants without previous AF at baseline from the UK Biobank, mean age 56.4 ± 8.1 years, 45.2%…

Comparison

Osteosarcopenia vs Reference group, sarcopenia alone, and…

Design

Cohort

Follow-up

median 13.8 [13.1;14.6] years

Key result

Osteosarcopenia was independently associated with an increased risk of incident atrial fibrillation (aHR 1.33; 95% CI 1.09-1.62) compared to the reference group.

Authors

KLKyung‐Yeon Lee TRTae-Min Rhee JCJungMin Choi

Discussion

Member takes

Overview

Osteosarcopenia may flag higher AF risk for screening consideration; extends observational links to incident AF but requires prospective validation before practice change.

Key Points

To investigate whether osteosarcopenia is associated with incident atrial fibrillation and evaluate its incremental prognostic value beyond established risk factors.
Analyzed baseline data from 482,137 participants without prior atrial fibrillation in the UK Biobank (mean age 56.4 ± 8.1 years; 45.2% male) over a median follow-up of 13.8 years.
Categorized participants into four groups: reference, sarcopenia alone, osteoporosis alone, and osteosarcopenia, using multivariable Cox regression to estimate incident atrial fibrillation risk.
Performed replication analysis using data from the independent H-PEACE cohort.
In the primary UK Biobank cohort, osteosarcopenia was present in 0.65% of individuals and showed the strongest independent association with incident atrial fibrillation (aHR: 1.33; 95% CI: 1.09–1.62).
Osteoporosis alone was significantly associated with incident atrial fibrillation (aHR: 1.18; 95% CI: 1.03–1.36), whereas sarcopenia alone was not (aHR: 1.05; 95% CI: 0.99–1.10).
Replication in the H-PEACE cohort confirmed a heightened risk of atrial fibrillation among individuals with osteosarcopenia (adjusted OR: 2.10; 95% CI: 1.06–4.13; P = 0.032).

Study Design

Type

Cohort (n=482,137)

Multicenter

Yes

Structured PICO

Does osteosarcopenia increase the risk of incident atrial fibrillation in adults without previous AF?

Population

482,137 participants without previous atrial fibrillation (mean age 56.4 years, 54.8% female) followed for a median of 13.8 years.

Exposure

Osteosarcopenia (concurrent reductions in skeletal muscle mass and bone mineral density)

Comparator

Reference group (no sarcopenia or osteoporosis), sarcopenia alone, and osteoporosis alone

Outcome

Incident AFhard clinical

Main Result

Hazard Ratio: 1.33 (95% CI 1.09–1.62)

Osteosarcopenia is independently associated with an increased risk of incident atrial fibrillation, suggesting a potential role for tailored AF screening in this population.

Limitations

The improvement in risk discrimination was limited.

Cite This Study

synapsesocial.com/papers/6aaba4611561938ee54ba360 https://doi.org/10.1016/j.jacasi.2026.08.006

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

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