School of Population Health (M431), University of Western Australia, Crawley, WA, 6009, Australia,
Eur J Epidemiol. 2014 Mar;29(3):181-90. doi: 10.1007/s10654-013-9875-y. Epub 2014 Jan 4.
Atrial fibrillation (AF) is the most common chronic arrhythmia in adults and its prevalence is increasing. Due to its serious cardiovascular complications there is a strong need to understand predisposing risk factors to develop effective prevention strategies. There are a few established risk factors but a number of further risk factors have been suggested including obesity, metabolic syndrome, sleep-disordered breathing, and inflammation. The aim of this study was to investigate established and emerging risk factors for AF in a cohort study of 4,267 adults in Busselton, Western Australia, without a history of AF at baseline in 1994/95 who were followed for 15 years for incident AF events. Baseline measurement included questionnaire, clinical assessment and blood sample. A total of 343 (8%) experienced AF during follow-up. Cox regression analysis confirmed advancing age, male sex, taller height, being on hypertension treatment and higher body mass index (BMI) as the major common risk factors (all p < 0.001). However, further modelling showed the effect of being on hypertension treatment may be stronger in women (p = 0.001) and the effect of BMI stronger in men (p = 0.004). After adjustment for these factors, no other factors were strongly related (p < 0.001) although short PR interval, history of valvular heart disease, stroke, chronic obstructive pulmonary disease, lung function and adiponectin level were marginally related (p < 0.05). This cohort study of predictors for incident AF has confirmed the major established risk factors. However, recently suggested potential novel risk factors for AF (inflammation, sleep-disordered breathing, glucose/metabolic disorders) were not confirmed in this study.
心房颤动（AF）是成年人中最常见的慢性心律失常，其患病率正在增加。由于其严重的心血管并发症，因此强烈需要了解易患风险因素，以制定有效的预防策略。有一些已确定的风险因素，但还有一些进一步的风险因素被提出，包括肥胖、代谢综合征、睡眠呼吸障碍和炎症。本研究的目的是在西澳大利亚州巴斯顿的一项队列研究中调查 AF 的已确立和新兴风险因素，该研究纳入了 1994/95 年基线时无 AF 病史的 4267 名成年人，随访 15 年以确定 AF 事件的发生。基线测量包括问卷调查、临床评估和血液样本。在随访期间，共有 343 人（8%）发生了 AF。Cox 回归分析证实，年龄增长、男性、身高较高、接受高血压治疗和较高的体重指数（BMI）是主要的常见风险因素（均 p < 0.001）。然而，进一步的模型构建表明，女性接受高血压治疗的效果可能更强（p = 0.001），而男性 BMI 的效果更强（p = 0.004）。在调整这些因素后，没有其他因素与 AF 强烈相关（p < 0.001），尽管短 PR 间期、瓣膜性心脏病、中风、慢性阻塞性肺疾病、肺功能和脂联素水平与 AF 有一定的相关性（p < 0.05）。本队列研究对预测 AF 事件的因素进行了确认，证实了主要的已确立风险因素。然而，最近提出的 AF 的潜在新型风险因素（炎症、睡眠呼吸障碍、葡萄糖/代谢紊乱）在本研究中并未得到证实。
