男性和女性的体重指数和腰围与心房颤动的联合关联。

Joint Associations Between Body Mass Index and Waist Circumference With Atrial Fibrillation in Men and Women.

机构信息

Clinical Trial Service Unit and Epidemiological Studies Unit Nuffield Department of Population Health University of Oxford United Kingdom.

Department of Vascular Surgery University Medical Center Utrecht Utrecht The Netherlands.

出版信息

J Am Heart Assoc. 2021 Apr 20;10(8):e019025. doi: 10.1161/JAHA.120.019025. Epub 2021 Apr 15.

Abstract

Background Associations between adiposity and atrial fibrillation (AF) might differ between sexes. We aimed to determine precise estimates of the risk of AF by body mass index (BMI) and waist circumference (WC) in men and women. Methods and Results Between 2008 and 2013, over 3.2 million adults attended commercial screening clinics. Participants completed health questionnaires and underwent physical examination along with cardiovascular investigations, including an ECG. We excluded those with cardiovascular and cardiac disease. We used multivariable logistic regression and determined joint associations of BMI and WC and the risk of AF in men and women by comparing likelihood ratio χ statistics. Among 2.1 million included participants 12 067 (0.6%) had AF. A positive association between BMI per 5 kg/m increment and AF was observed, with an odds ratio of 1.65 (95% CI, 1.57-1.73) for men and 1.36 (95% CI, 1.30-1.42) for women among those with a BMI above 20 kg/m. We found a positive association between AF and WC per 10 cm increment, with an odds ratio of 1.47 (95% CI, 1.36-1.60) for men and 1.37 (95% CI, 1.26-1.49) for women. Improvement of likelihood ratio χ was equal after adding BMI and WC to models with all participants. In men, WC showed stronger improvement of likelihood ratio χ than BMI (30% versus 23%). In women, BMI showed stronger improvement of likelihood ratio χ than WC (23% versus 12%). Conclusions We found a positive association between BMI (above 20 kg/m2) and AF and between WC and AF in both men and women. BMI seems a more informative measure about risk of AF in women and WC seems more informative in men.

摘要

背景

肥胖与心房颤动(AF)之间的关联可能因性别而异。我们旨在确定男性和女性的体重指数(BMI)和腰围(WC)与 AF 风险之间的精确风险估计。

方法和结果

在 2008 年至 2013 年间,超过 320 万成年人参加了商业筛查诊所。参与者完成了健康问卷,并接受了身体检查以及心血管检查,包括心电图。我们排除了患有心血管和心脏疾病的患者。我们使用多变量逻辑回归,并通过比较似然比 χ 统计量来确定 BMI 和 WC 与男性和女性 AF 风险的联合关联。在 2.1 万名纳入的参与者中,有 12067 人(0.6%)患有 AF。观察到 BMI 每增加 5kg/m,AF 的风险呈正相关,对于 BMI 超过 20kg/m 的人群,男性的比值比为 1.65(95%CI,1.57-1.73),女性为 1.36(95%CI,1.30-1.42)。我们发现,随着 WC 每增加 10cm,AF 的风险呈正相关,男性的比值比为 1.47(95%CI,1.36-1.60),女性为 1.37(95%CI,1.26-1.49)。在所有参与者的模型中,加入 BMI 和 WC 后,似然比 χ 的改善程度相等。在男性中,WC 对似然比 χ 的改善程度大于 BMI(30%比 23%)。在女性中,BMI 对似然比 χ 的改善程度大于 WC(23%比 12%)。

结论

我们发现,BMI(超过 20kg/m2)与 AF 之间以及 WC 与男性和女性 AF 之间存在正相关关系。BMI 似乎是女性 AF 风险的更具信息量的指标,而 WC 似乎在男性中更具信息量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3877/8174185/65753fa18324/JAH3-10-e019025-g001.jpg

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