Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, China.
Nutritional Epidemiology, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
BMC Med. 2024 Aug 26;22(1):345. doi: 10.1186/s12916-024-03565-y.
Epidemiological evidence on weight change and atrial fibrillation (AF) remains limited and inconsistent. Previous studies on body mass index (BMI) in youth and AF rarely considered subsequent BMI. This study aimed to assess the associations of AF with weight change and BMI in youth, as well as modified effect by genetic susceptibility of AF.
The study included 21,761 individuals (mean age 57.8 years) from the Malmö Diet and Cancer cohort. Weight information was obtained at three time points, including recalled weight at age 20 years, measured weight at baseline (middle adulthood), and reported weight at 5-year follow-up examination (late middle adulthood). A weighted genetic risk score of AF was created using 134 variants.
During a median follow-up of 23.2 years, a total of 4038 participants developed AF. The association between weight change from early to middle adulthood and AF risk was modified by sex (P = 0.004); weight loss was associated with a lower AF risk in females, but not in males. Conversely, weight gain was positively associated with AF risk in a linear manner in females, whereas increased AF risk appeared only when weight gain exceeded a threshold in males. Participants with weight gain of > 5 kg from middle to late middle adulthood had a 19% higher risk of AF relative to those with stable weight, whereas weight loss showed a null association. Compared to individuals with a lower BMI at age 20 years, those with a BMI above 25 kg/m had an increased risk of AF (HR = 1.14; 95% CI: 1.02-1.28), after controlling for baseline BMI; this association was more pronounced in males or those with a lower genetic risk of AF.
Weight gain in middle adulthood was associated with higher AF risk. Weight loss from early to middle adulthood, but not from middle to late middle adulthood, was associated with a lower risk of AF only in females. Higher BMI in youth was associated with an increased risk of AF, particularly among males or those with a lower genetic risk of AF.
体重变化与心房颤动（AF）的流行病学证据仍然有限且不一致。之前关于年轻人 BMI 与 AF 的研究很少考虑到后续 BMI。本研究旨在评估体重变化和 BMI 与年轻人 AF 的关联，以及 AF 的遗传易感性对其的修正作用。
该研究纳入了来自马尔默饮食与癌症队列的 21761 名个体（平均年龄 57.8 岁）。体重信息在三个时间点获得，包括 20 岁时的回忆体重、基线时（中年）的测量体重和 5 年随访检查时（中老年）的报告体重。使用 134 个变体创建了 AF 的加权遗传风险评分。
在中位随访 23.2 年期间，共有 4038 名参与者发生 AF。从青年到中年的体重变化与 AF 风险之间的关联受到性别的修饰（P=0.004）；在女性中，体重减轻与 AF 风险降低相关，而在男性中则不然。相反，在女性中，体重增加与 AF 风险呈线性正相关，而在男性中，只有当体重增加超过一定阈值时，AF 风险才会增加。从中年到中老年期间体重增加>5kg 的参与者发生 AF 的风险比体重稳定的参与者高 19%，而体重减轻则无关联。与 20 岁时 BMI 较低的个体相比，BMI 超过 25kg/m 的个体发生 AF 的风险增加（HR=1.14；95%CI：1.02-1.28），控制了基线 BMI 后；这种关联在男性或 AF 遗传风险较低的个体中更为明显。
中年时的体重增加与 AF 风险增加相关。从中年到中老年期间的体重减轻与 AF 风险降低相关，但仅在女性中相关。年轻时 BMI 较高与 AF 风险增加相关，尤其是在男性或 AF 遗传风险较低的个体中。
