General obesity and abdominal obesity were associated with an increased risk of incident atrial fibrillation compared to normal weight and waist circumference (HR 1.73 and 1.38, respectively), whereas variability in these measures was not.
Cohort (n=44,135)
Yes
Do elevated levels and high variability of body mass index and waist circumference increase the risk of incident atrial fibrillation in a Chinese cohort?
Elevated levels of BMI and waist circumference, but not their variability, are independently associated with an increased risk of incident atrial fibrillation.
Hazard Ratio: 1.73 (95% CI 1.31–2.3)
Absolute Event Rate: 1.39% vs 0.8%
BACKGROUND: Although obesity has been associated with risk of atrial fibrillation (AF), the associations of variability of obesity measures with AF risk are uncertain, and longitudinal studies among Chinese population are still lacking. We aimed to evaluate the impacts of obesity and variability of body mass index (BMI) and waist circumference (WC) on the risk of atrial fibrillation (AF) in a large Chinese cohort study. METHODS: A total of 44,135 participants of the Kailuan Study who were free of cancer and cardiovascular disease and underwent three consecutive surveys from 2006 to 2010 were followed for incident AF until 2020. Average BMI and WC over time and variability were calculated. Cox proportional hazards regression models were used to assess hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations of obesity and variability in BMI and WC with AF risk. RESULTS: During a mean follow-up of 9.68 years, there were 410 cases of incident AF. In multivariable-adjusted models, compared with normal BMI/WC, individuals with general obesity and abdominal obesity had increased risk of AF, with corresponding HRs of 1.73 (95% CI: 1.31-2.30) and 1.38 (95% CI: 1.11-1.60), respectively. The short-term elevation in AF risk persisted for the obese even after adjustment for updated biologic intermediaries and weight. Variability in BMI and WC were not associated with the risk of AF. The restricted cubic spline models indicated significant linear relationships between levels of WC and BMI and risk of AF. CONCLUSIONS: Elevated levels of BMI and WC were associated with an increased risk of AF, whereas variability in BMI and WC were not. Therefore, achieving optimal levels of BMI and WC could be valuable in AF prevention.
Zhao et al. (2022) conducted a cohort in Atrial fibrillation (n=44,135). General obesity (BMI ≥ 28 kg/m²) vs. Normal weight (BMI 18.5-23.9 kg/m²) was evaluated on Incident atrial fibrillation (HR 1.73, 95% CI 1.31-2.30). General obesity and abdominal obesity were associated with an increased risk of incident atrial fibrillation compared to normal weight and waist circumference (HR 1.73 and 1.38, respectively), whereas variability in these measures was not.