Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
PLoS One. 2021 Feb 18;16(2):e0246907. doi: 10.1371/journal.pone.0246907. eCollection 2021.
Limited causal evidence is available on the relationship between body mass index (BMI) and atrial fibrillation (AF) progression. Sex differences have been noted and may be relevant for AF progression. We investigated the association between the BMI Genetic Risk Score (GRS) and AF progression in men and women of the Groningen Genetic Atrial Fibrillation (GGAF) cohort.
The GGAF cohort (n = 2207) is a composite of 5 prospective cohorts with individuals of European ancestry. AF patients with genetic information, with at least 12 months follow-up and AF progression data were included. AF progression was defined as progression from paroxysmal to persistent/permanent AF, or persistent to permanent AF. A BMI GRS was constructed of genetic variants associated with BMI. Univariate and multivariate Cox proportional hazard regression analyses were performed in the total population and in men and women, separately. During a median follow-up of 34 [interquartile range 19-48] months 630 AF patients (mean age 62±11, 36% women, BMI of 28±5) were analyzed, and men and women developed similar AF progression rates (respectively 6.5% versus 6.1%). The BMI GRS was not associated with AF progression either as a continuous variable or in tertiles in the overall population. However, the BMI GRS was associated with the tertile of the highest BMI GRS in women (n = 225), also after multivariable adjustments of clinical risk factors (Hazard ratio 2.611 (95% confidence interval 1.151-5.924) p = 0.022).
Genetically-determined BMI is only associated with women at risk of AF progression. The results may be supporting evidence for a causal link between observed BMI and AF progression in women. We emphasize the need for further investigation of genetically determined BMI and observed BMI to optimize AF management in women with increased risk for AF progression.
关于体重指数（BMI）与心房颤动（AF）进展之间的关系，目前仅有有限的因果证据。已经注意到性别差异，并且可能与 AF 进展有关。我们研究了 BMI 遗传风险评分（GRS）与 Groningen 遗传心房颤动（GGAF）队列中男性和女性的 AF 进展之间的关系。
GGAF 队列（n = 2207）是由 5 个具有欧洲血统的前瞻性队列组成的组合。纳入具有遗传信息、至少有 12 个月随访和 AF 进展数据的 AF 患者。AF 进展定义为从阵发性转为持续性/永久性 AF，或持续性转为永久性 AF。构建了与 BMI 相关的遗传变异的 BMI GRS。在总人群以及男性和女性中分别进行了单变量和多变量 Cox 比例风险回归分析。在中位数为 34 [四分位距 19-48] 个月的随访期间，分析了 630 名 AF 患者（平均年龄 62±11 岁，36%为女性，BMI 为 28±5），男性和女性的 AF 进展率相似（分别为 6.5%和 6.1%）。BMI GRS 无论是作为连续变量还是作为三分位数，与总体人群的 AF 进展均无相关性。然而，BMI GRS 与女性 BMI GRS 最高三分位的 tertile 相关（n = 225），即使在对临床危险因素进行多变量调整后也是如此（危险比 2.611（95%置信区间 1.151-5.924）p = 0.022）。
遗传决定的 BMI 仅与有 AF 进展风险的女性相关。这些结果可能为观察到的 BMI 与女性 AF 进展之间的因果关系提供支持证据。我们强调需要进一步研究遗传决定的 BMI 和观察到的 BMI，以优化有 AF 进展风险的女性的 AF 管理。
