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心房颤动患者营养状况的临床意义:当前证据概述

Clinical significance of nutritional status in patients with atrial fibrillation: An overview of current evidence.

作者信息

Anaszewicz Marzena, Budzyński Jacek

机构信息

Clinic of Vascular and Internal Diseases, Jan Biziel University Hospital No. 2 in Bydgoszcz, Bydgoszcz, Poland.

Clinic of Vascular and Internal Diseases, Jan Biziel University Hospital No. 2 in Bydgoszcz, Bydgoszcz, Poland; Department of Vascular and Internal Diseases; Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland.

出版信息

J Cardiol. 2017 May;69(5):719-730. doi: 10.1016/j.jjcc.2016.06.014. Epub 2016 Aug 9.

Abstract

BACKGROUND

Obesity is a well-known atherosclerosis risk factor; however, its role and the importance of undernutrition in atrial fibrillation (AF) pathogenesis are still not well understood. The aim of this study was to present the current state of knowledge on this issue in different groups of patients.

METHODS

Systematic review of papers published between 1980 and 2016.

RESULTS

The literature shows contradicting views regarding the impact of nutritional status on the risk, course, and complications of AF. On the one hand, it has been revealed that overweight, obesity, and high birth mass increase the risk of AF, and that their reduction is linked to an improved course of AF and reduced all-cause and cardiovascular mortality. On the other hand, a so-called obesity paradox has been found, which shows lower all-cause mortality in overweight patients with AF compared to those of normal weight or who are underweight. It has also been shown, although based on a small number of studies, that the relationship between nutritional status and risk of AF and its complication may be U-shaped, which means that not only patients with obesity, but also individuals with underweight, cachexia, and low birth weight may have an increased risk and poor outcome of AF.

CONCLUSIONS

The relationship between patients' nutritional status and the course of AF has become clearer but it requires further studies examining the importance of weight reduction on AF course.

摘要

背景

肥胖是众所周知的动脉粥样硬化风险因素;然而,其在心房颤动(AF)发病机制中的作用以及营养不良的重要性仍未得到充分理解。本研究的目的是呈现不同患者群体中关于该问题的当前知识状态。

方法

对1980年至2016年间发表的论文进行系统综述。

结果

文献显示,关于营养状况对AF风险、病程及并发症的影响存在相互矛盾的观点。一方面,研究表明超重、肥胖和高出生体重会增加AF风险,减轻这些因素与改善AF病程以及降低全因死亡率和心血管死亡率相关。另一方面,发现了所谓的肥胖悖论,即与体重正常或体重过轻的AF患者相比,超重的AF患者全因死亡率更低。尽管基于少数研究,但也表明营养状况与AF风险及其并发症之间的关系可能呈U形,这意味着不仅肥胖患者,而且体重过轻、恶病质和低出生体重的个体患AF的风险可能增加且预后较差。

结论

患者营养状况与AF病程之间的关系已变得更加清晰,但仍需要进一步研究来探讨减轻体重对AF病程的重要性。

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