Alfred and Gail Engelberg Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, New York.
Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York.
Am J Epidemiol. 2018 Mar 1;187(3):417-426. doi: 10.1093/aje/kwx255.
Tall stature and obesity have been associated with a higher risk of atrial fibrillation (AF), but there have been conflicting reports of the effects of aerobic fitness. We conducted a national cohort study to examine interactions between height or weight and level of aerobic fitness among 1,547,478 Swedish military conscripts during 1969-1997 (97%-98% of all 18-year-old men) in relation to AF identified from nationwide inpatient and outpatient diagnoses through 2012 (maximal age, 62 years). Increased height, weight, and aerobic fitness level (but not muscular strength) at age 18 years were all associated with a higher AF risk in adulthood. Positive additive and multiplicative interactions were found between height or weight and aerobic fitness level (for the highest tertiles of height and aerobic fitness level vs. the lowest, relative excess risk = 0.51, 95% confidence interval (CI): 0.40, 0.62; ratio of hazard ratios = 1.50, 95% CI: 1.34, 1.65). High aerobic fitness levels were associated with higher risk among men who were at least 186 cm (6 feet, 1 inch) tall but were protective among shorter men. Men with the combination of tall stature and high aerobic fitness level had the highest risk (for the highest tertiles vs. the lowest, adjusted hazard ratio = 1.70, 95% CI: 1.61, 1.80). These findings suggest important interactions between body size and aerobic fitness level in relation to AF and may help identify high-risk subgroups.
高身材和肥胖与心房颤动 (AF) 的风险增加有关，但关于有氧健身对 AF 的影响却存在相互矛盾的报告。我们进行了一项全国性队列研究，以检查身高或体重与 1969 年至 1997 年期间瑞典军事应征者的有氧健身水平之间的相互作用（97%-98%的所有 18 岁男性），这些应征者在 2012 年之前通过全国性住院和门诊诊断确定患有 AF（最大年龄为 62 岁）。18 岁时身高、体重和有氧健身水平的增加都与成年后患 AF 的风险增加有关。发现身高或体重与有氧健身水平之间存在正的附加和乘法相互作用（与身高和有氧健身水平的最高三分位数相比，最低三分位数，相对超额风险 = 0.51，95%置信区间 (CI)：0.40，0.62；风险比的比值 = 1.50，95%CI：1.34，1.65）。高有氧健身水平与身高至少 186 厘米（6 英尺 1 英寸）的男性的较高风险相关，但在身材较矮的男性中具有保护作用。身材高大且有氧健身水平高的男性组合具有最高的风险（与最低三分位数相比，调整后的风险比 = 1.70，95%CI：1.61，1.80）。这些发现表明，在 AF 方面，身体大小和有氧健身水平之间存在重要的相互作用，这可能有助于识别高风险亚组。
