体质指数与心房颤动患者全因死亡率：来自中国心房颤动注册研究的启示。
Body mass index and all-cause mortality in patients with atrial fibrillation: insights from the China atrial fibrillation registry study.
机构信息
Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, No. 2 Beijing Anzhen Road, Chaoyang District, Beijing, 100029, China.
Heart Health Research Center, Beijing, China.
出版信息
Clin Res Cardiol. 2019 Dec;108(12):1371-1380. doi: 10.1007/s00392-019-01473-3. Epub 2019 Apr 5.
BACKGROUND
Impact of body mass index (BMI) on all-cause mortality in atrial fibrillation (AF) patients remains controversial.
METHODS
A total of 10,942 AF patients were prospectively enrolled and categorized into four BMI groups: underweight (BMI < 18.5 kg/m), normal weight (BMI 18.5-24 kg/m), overweight (BMI 24-28 kg/m) and obesity (BMI ≥ 28 kg/m). The primary outcome was all-cause mortality. Different Cox proportional hazards models were performed to evaluate the association between BMI and all-cause mortality.
RESULTS
During a median follow-up of 30 months (IQR 18-48 months), 862 deaths events occurred. Compared to normal BMI, higher BMI was associated with a lower mortality risk (overweight: HR 0.70; 95% CI 0.61-0.81, P < 0.0001 and obesity: HR 0.54; 95% CI 0.44-0.67, P < 0.0001) and lower BMI was associated with a higher mortality risk (HR 2.23, 95% CI 1.67-2.97, P < 0.0001).
CONCLUSION
A reversed relationship between BMI and all-cause mortality in AF patients was found. Higher risk of mortality was observed in underweight patients compared to patients with a normal BMI, while overweight and obese patients had a lower risk of all-cause mortality.
CLINICAL TRIAL REGISTRATION
URL: http://www.chictr.org.cn/showproj.aspx?proj=5831. Unique identifier: ChiCTR-OCH-13003729.
背景
体重指数（BMI）对心房颤动（AF）患者全因死亡率的影响仍存在争议。
方法
共前瞻性纳入 10942 例 AF 患者，并分为四组 BMI 组：体重不足（BMI<18.5kg/m）、正常体重（BMI 18.5-24kg/m）、超重（BMI 24-28kg/m）和肥胖（BMI≥28kg/m）。主要结局是全因死亡率。采用不同的 Cox 比例风险模型评估 BMI 与全因死亡率之间的关系。
结果
在中位 30 个月（IQR 18-48 个月）的随访期间，发生了 862 例死亡事件。与正常 BMI 相比，较高的 BMI 与较低的死亡率风险相关（超重：HR 0.70；95%CI 0.61-0.81，P<0.0001；肥胖：HR 0.54；95%CI 0.44-0.67，P<0.0001），而较低的 BMI 与较高的死亡率风险相关（HR 2.23，95%CI 1.67-2.97，P<0.0001）。
结论
在 AF 患者中发现 BMI 与全因死亡率之间呈反向关系。与正常 BMI 的患者相比，体重不足的患者死亡风险更高，而超重和肥胖的患者全因死亡率较低。
临床试验注册
网址：http://www.chictr.org.cn/showproj.aspx?proj=5831. 唯一标识符：ChiCTR-OCH-13003729.
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