Ahn Hyo-Jeong, Lee So-Ryoung, Choi Eue-Keun, Han Kyung-Do, Rhee Tae-Min, Kwon Soonil, Kim Sunwha, Oh Seil, Lip Gregory Y H
Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea.
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.
Front Cardiovasc Med. 2022 Aug 1;9:906844. doi: 10.3389/fcvm.2022.906844. eCollection 2022.
OBJECTIVE: Obesity and aging are important predisposing factors to atrial fibrillation (AF) and ischaemic stroke (IS). However, limited data comprehensively evaluated the relationships between obesity measurements and AF and IS in different ages. METHODS: A total of 9,432,332 adults from the Korean National Health Insurance Service Database were included. The study population was categorized into the six age subgroups by an increase every decade from the twenties. We evaluated AF and IS risk according to body mass index (BMI) and waist circumference (WC) in the different age groups. RESULTS: During a mean follow-up of 8.2 ± 1.0 years, BMI-AF presented a J-shaped association across ages. The highest hazard ratio (HR) of the BMI ≥ 30 kg/m group was observed in subjects aged 30-39 years [HR 1.80, 95% CI 1.63-1.98, < 0.001]. Underweight adults over 60 years also presented an increased AF risk. Incident IS risk increased in those with BMI over the normal range in early and midlife, but the association became obscured in adults aged > 60 years. Among the BMI ≥ 30 kg/m groups, subjects aged 20-29 years presented the highest risk of IS [HR 3.00, 95% CI (2.34-3.84), < 0.001]. Overall, WC-AF and WC-IS showed positive linear correlations, but the WC-IS association was weak in subjects aged ≥ 40 years. CONCLUSION: The higher risks of AF and IS according to an increment of BMI and WC were most apparent among the young ages. The association between obesity measurements and IS was not significantly above the midlife. Weight management in the young and integrated risk factor management in the elderly are warranted.
目的:肥胖和衰老都是心房颤动(AF)和缺血性卒中(IS)的重要诱发因素。然而,全面评估不同年龄段肥胖指标与AF及IS之间关系的数据有限。 方法:纳入了韩国国民健康保险服务数据库中的9432332名成年人。研究人群按照从二十多岁开始每十年递增的方式分为六个年龄亚组。我们在不同年龄组中根据体重指数(BMI)和腰围(WC)评估AF和IS风险。 结果:在平均8.2±1.0年的随访期间,BMI-AF在各年龄段呈现J形关联。BMI≥30kg/m²组的最高风险比(HR)出现在30-39岁的受试者中[HR 1.80,95%CI 1.63-1.98,P<0.001]。60岁以上的体重过轻成年人也呈现出AF风险增加。在中青年时期,BMI超过正常范围者的IS发病风险增加,但在60岁以上成年人中这种关联变得不明显。在BMI≥30kg/m²组中,20-29岁的受试者IS风险最高[HR 3.00,95%CI(2.34-3.84),P<0.001]。总体而言,WC-AF和WC-IS呈现正线性相关,但在40岁及以上受试者中WC-IS关联较弱。 结论:根据BMI和WC增加所导致的AF和IS较高风险在年轻人中最为明显。肥胖指标与IS之间的关联在中年以后并不显著。有必要对年轻人进行体重管理,对老年人进行综合危险因素管理。
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