动脉粥样硬化多民族研究和杰克逊心脏研究中的心包脂肪体积与房颤发生率

Pericardial fat volume and incident atrial fibrillation in the Multi-Ethnic Study of Atherosclerosis and Jackson Heart Study.

作者信息

Heckbert Susan R, Wiggins Kerri L, Blackshear Chad, Yang Yi, Ding Jingzhong, Liu Jiankang, McKnight Barbara, Alonso Alvaro, Austin Thomas R, Benjamin Emelia J, Curtis Lesley H, Sotoodehnia Nona, Correa Adolfo

机构信息

Department of Epidemiology, University of Washington, Seattle, Washington, USA.

Department of Medicine, University of Washington, Seattle, Washington, USA.

出版信息

Obesity (Silver Spring). 2017 Jun;25(6):1115-1121. doi: 10.1002/oby.21835. Epub 2017 Apr 28.

DOI:10.1002/oby.21835

PMID:28452401

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5445011/

Abstract

OBJECTIVE

To determine whether greater pericardial fat volume would be associated with increased risk of incident atrial fibrillation (AF).

METHODS

In the Multi-Ethnic Study of Atherosclerosis and Jackson Heart Study, pericardial fat volume was quantified by computed tomography. Incident AF was identified from discharge diagnosis codes, study electrocardiograms, and Medicare claims.

RESULTS

Among 7,991 participants, 40% were African American, 32% white, 18% Hispanic, and 10% Chinese American; mean age was 62 years; 55% were women. During an average of 10.0 years of follow-up in the Multi-Ethnic Study of Atherosclerosis and 4.5 years in the Jackson Heart Study, 756 incident AF cases were identified. After adjustment for age, sex, study, race/ethnicity, height, glucose status, systolic blood pressure, treated hypertension, and BMI, greater pericardial fat volume was associated with higher AF risk in Hispanics (hazard ratio 1.24 per SD, 95% confidence interval 1.05-1.46) but not overall (hazard ratio 1.06, 95% confidence interval 0.97-1.15). In mediation analysis, pericardial fat volume partially mediated the association of BMI with incident AF in Hispanics.

CONCLUSIONS

After adjustment for BMI, greater pericardial fat volume was associated with incident AF in Hispanics but not overall. Additional research is needed on the mechanisms by which pericardial fat volume is related to increased AF risk and possible differences by race/ethnicity.

摘要

目的

确定心包脂肪体积增加是否与新发心房颤动（AF）风险增加相关。

方法

在动脉粥样硬化多民族研究和杰克逊心脏研究中，通过计算机断层扫描对心包脂肪体积进行量化。从出院诊断代码、研究心电图和医疗保险索赔中识别新发AF。

结果

在7991名参与者中，40%为非裔美国人，32%为白人，18%为西班牙裔，10%为华裔美国人；平均年龄为62岁；55%为女性。在动脉粥样硬化多民族研究平均10.0年的随访期间以及杰克逊心脏研究4.5年的随访期间，共识别出756例新发AF病例。在对年龄、性别、研究、种族/民族、身高、血糖状态、收缩压、治疗的高血压和BMI进行调整后，心包脂肪体积增加与西班牙裔人群AF风险较高相关（每标准差风险比1.24，95%置信区间1.05 - 1.46），但总体上并非如此（风险比1.06，95%置信区间0.97 - 1.15）。在中介分析中，心包脂肪体积部分介导了西班牙裔人群中BMI与新发AF的关联。