Zhao Maoxiang, Du Wenjuan, Zhao Qianqian, Chen Yating, Li Bin, Xie Zhonghui, Fu Zihao, Zhang Nan, Cheng Xiaowei, Li Xiaoqian, Yao Siyu, Wang Miao, Wang Chi, Wu Shouling, Xue Hao, Li Yang
Department of Cardiology, First Medical Center, Chinese People's Liberation Army Hospital, Medical School of Chinese People's Liberation Army, Beijing, China.
Laboratory of Radiation Injury Treatment, Medical Innovation Research Division, PLA General Hospital, Beijing, China.
Front Cardiovasc Med. 2022 Jun 28;9:888062. doi: 10.3389/fcvm.2022.888062. eCollection 2022.
Atrial fibrillation (AF) is associated with both obesity and its metabolic consequences. However, there is a paucity of information on whether the dynamic change of metabolic health and obesity phenotypes affect the risk of AF. We aimed to prospectively examine the association between metabolic health and its change over time and AF risk across body mass index (BMI) categories.
A total of 58,483 participants without history of cancer, and cardiovascular diseases from the Kailuan study were included in the present study. Transition of metabolic phenotypes was evaluated between 1st survey (2006-2007) and the 2nd survey (2008-2009). The hazard ratios (HRs) and 95% confidence intervals (CIs) for AF were assessed by Cox proportional hazards regression.
During a median follow-up of 3 years, we documented 580 cases of AF. Compared with metabolically healthy individuals with normal weight, the multivariable-adjusted hazard ratios for metabolically healthy and unhealthy overweight/obese were 1.27 (95% : 1.01, 1.59) and 1.37 (95% : 1.09, 1.72), respectively. However, when transition was taken into account, overweight/obese people who maintained metabolically healthy status were not associated with increased long-term risk (, 1.11;95% : 0.70, 1.78), whereas participants who converted from metabolically healthy overweight/obese status to an unhealthy phenotype had higher AF risk than those who maintained metabolically healthy normal weight ( 1.59, 95% : 1.11, 2.26). When BMI and metabolically healthy status were updated over the course of the study, significant short-term elevations in AF risk were associated with individuals with stable MU-OW/OB status.
In this community-based cohort study, metabolically healthy overweight/obese individuals have increased risks of AF. Obesity remains a risk factor for AF independent of major metabolic factors. Our data further suggested that metabolic phenotype was a dynamic condition, and maintenance of metabolic health and normal weight might alleviate the risk of AF.
心房颤动（AF）与肥胖及其代谢后果相关。然而，关于代谢健康和肥胖表型的动态变化是否会影响房颤风险的信息却很少。我们旨在前瞻性地研究代谢健康及其随时间的变化与不同体重指数（BMI）类别中房颤风险之间的关联。
本研究纳入了开滦研究中58483名无癌症和心血管疾病病史的参与者。在第一次调查（2006 - 2007年）和第二次调查（2008 - 2009年）之间评估代谢表型的转变。通过Cox比例风险回归评估房颤的风险比（HRs）和95%置信区间（CIs）。
在中位随访3年期间，我们记录了580例房颤病例。与体重正常的代谢健康个体相比，代谢健康和不健康的超重/肥胖个体的多变量调整风险比分别为1.27（95%：1.01，1.59）和1.37（95%：1.09，1.72）。然而，当考虑到转变情况时，维持代谢健康状态的超重/肥胖人群与长期风险增加无关（HR = 1.11；95%：0.70，1.78），而从代谢健康的超重/肥胖状态转变为不健康表型的参与者比维持代谢健康正常体重的参与者有更高的房颤风险（HR = 1.59，95%：1.11，2.26）。当在研究过程中更新BMI和代谢健康状态时，房颤风险的显著短期升高与稳定的中度超重/肥胖（MU - OW/OB）状态个体相关。
在这项基于社区的队列研究中，代谢健康的超重/肥胖个体患房颤的风险增加。肥胖仍然是独立于主要代谢因素的房颤风险因素。我们的数据进一步表明，代谢表型是一种动态状况，维持代谢健康和正常体重可能会降低房颤风险。
