代谢健康型肥胖与心房颤动之间的关联：纵向研究的系统评价与荟萃分析

Association between metabolically healthy obesity and atrial fibrillation: A systematic review and meta-analysis of longitudinal studies.

作者信息

Liu Xiao, Ling Jitao, Wu Yifan, Zhao Huilei, Hu Yuzhe, Yan Zhiwei, Zhu Wengen, Yu Peng, Wang Jinfeng, Zhang Yuling, Bucci Tommaso, Lip Gregory Y H

机构信息

Department of Cardiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, Guangdong, China; Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore Medical School, Singapore, Singapore.

Department of Endocrinology and Metabolism, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.

出版信息

Diabetes Metab Syndr. 2025 Apr;19(4):103228. doi: 10.1016/j.dsx.2025.103228. Epub 2025 Apr 21.

DOI:10.1016/j.dsx.2025.103228

PMID:40306065

Abstract

INTRODUCTION

Obesity is not a single diagnosis, and the association of 'metabolically unhealthy' obesity with cardiovascular disease is well-described. However, the relationship between metabolically healthy obesity (MHO) and atrial fibrillation (AF) is still debated.

OBJECTIVE

Our objective is to investigate the association between MHO and the risk of AF.

METHODS

A comprehensive search of databases, including PubMed, EMBASE, Web of Science, and the Cochrane Library regarding longitudinal studies of MHO and risk of AF was performed. Random effects were used to pool the effect estimates.

RESULTS

Nine cohort studies comprising 4,250,557 participants were included. The pooled results revealed that individuals with MHO were associated with a greater incidence of AF than those with a metabolically healthy normal weight (HR: 1.34, 95 % CI: 1.26 to 1.42) with moderate certainty according to the Grading of Recommendations Assessment, Development, and Evaluation assessment. Individuals with MHO were associated with a lower risk of AF compared with participants with metabolically unhealthy obesity (RR: 0.48, 95 % CI: 0.36 to 0.64). Individuals with MHO were not significantly associated with the risk of AF as compared to metabolically unhealthy normal weight (HR: 1.04, 95 % CI: 0.89 to 1.22).

CONCLUSION

MHO is associated with a greater incidence of AF, highlighting the importance of weight reduction in individuals without metabolic disorders in reducing the risk of AF.

REGISTRATION

PROSPERO - registration number CRD42023432195.

摘要

引言

肥胖并非单一诊断，“代谢不健康”肥胖与心血管疾病的关联已得到充分描述。然而，代谢健康肥胖（MHO）与心房颤动（AF）之间的关系仍存在争议。

目的

我们的目的是研究MHO与AF风险之间的关联。

方法

对包括PubMed、EMBASE、Web of Science和Cochrane图书馆在内的数据库进行全面检索，以查找关于MHO和AF风险的纵向研究。采用随机效应合并效应估计值。

结果

纳入了9项队列研究，共4250557名参与者。汇总结果显示，根据推荐分级评估、制定和评价评估，MHO个体发生AF的发生率高于代谢健康正常体重个体（HR：1.34，95%CI：1.26至1.42），具有中等确定性。与代谢不健康肥胖参与者相比，MHO个体发生AF的风险较低（RR：0.48，95%CI：0.36至0.64）。与代谢不健康正常体重个体相比，MHO个体与AF风险无显著关联（HR：1.04，95%CI：0.89至1.22）。