Department of Cardiology, The First Medical Center, Chinese People's Liberation Army Hospital, Medical School of Chinese People's Liberation Army, Beijing, China.
Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
BMC Med. 2022 Jun 29;20(1):215. doi: 10.1186/s12916-022-02413-1.
Although obesity has been associated with risk of atrial fibrillation (AF), the associations of variability of obesity measures with AF risk are uncertain, and longitudinal studies among Chinese population are still lacking. We aimed to evaluate the impacts of obesity and variability of body mass index (BMI) and waist circumference (WC) on the risk of atrial fibrillation (AF) in a large Chinese cohort study.
A total of 44,135 participants of the Kailuan Study who were free of cancer and cardiovascular disease and underwent three consecutive surveys from 2006 to 2010 were followed for incident AF until 2020. Average BMI and WC over time and variability were calculated. Cox proportional hazards regression models were used to assess hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations of obesity and variability in BMI and WC with AF risk.
During a mean follow-up of 9.68 years, there were 410 cases of incident AF. In multivariable-adjusted models, compared with normal BMI/WC, individuals with general obesity and abdominal obesity had increased risk of AF, with corresponding HRs of 1.73 (95% CI: 1.31-2.30) and 1.38 (95% CI: 1.11-1.60), respectively. The short-term elevation in AF risk persisted for the obese even after adjustment for updated biologic intermediaries and weight. Variability in BMI and WC were not associated with the risk of AF. The restricted cubic spline models indicated significant linear relationships between levels of WC and BMI and risk of AF.
Elevated levels of BMI and WC were associated with an increased risk of AF, whereas variability in BMI and WC were not. Therefore, achieving optimal levels of BMI and WC could be valuable in AF prevention.
尽管肥胖与心房颤动（AF）风险相关，但肥胖测量值的变异性与 AF 风险的关联尚不确定，且针对中国人群的纵向研究仍然缺乏。我们旨在评估 BMI 和腰围（WC）的肥胖和变异性对大型中国队列研究中 AF 风险的影响。
共有 44135 名来自开滦研究的参与者，他们在研究期间无癌症和心血管疾病，并在 2006 年至 2010 年期间进行了三次连续调查，随访至 2020 年发生 AF。计算了随时间变化的平均 BMI 和 WC 以及变异性。使用 Cox 比例风险回归模型评估肥胖和 BMI 及 WC 变异性与 AF 风险的关联的危险比（HR）和 95%置信区间（CI）。
在平均 9.68 年的随访期间，有 410 例发生了 AF。在多变量调整模型中，与正常 BMI/WC 相比，一般肥胖和腹型肥胖者发生 AF 的风险增加，相应的 HR 分别为 1.73（95%CI：1.31-2.30）和 1.38（95%CI：1.11-1.60）。即使调整了更新的生物学中间指标和体重，肥胖者的 AF 风险短期升高仍然持续存在。BMI 和 WC 的变异性与 AF 风险无关。受限三次样条模型表明，WC 和 BMI 的水平与 AF 风险之间存在显著的线性关系。
升高的 BMI 和 WC 水平与 AF 风险增加相关，而 BMI 和 WC 的变异性与 AF 风险无关。因此，达到 BMI 和 WC 的最佳水平可能对 AF 的预防有价值。
