Big men and atrial fibrillation: effects of body size and weight gain on risk of atrial fibrillation in men
Big men and atrial fibrillation: effects of body size and weight gain on risk of atrial fibrillation in men
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DOI：
10.1093/eurheartj/ehp076
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发表时间：
2009-05-01
影响因子：
39.3
通讯作者：
Swedberg, Karl
中科院分区：
文献类型：
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作者：
Rosengren, Annika;Hauptman, Paul J.;Swedberg, Karl
肥胖是房颤（AF）的公认危险因素，部分原因是体重指数（BMI）与心房容积之间存在相关性。我们的目的是确定是否其他因素有关的身体大小与AF。数据来自随机人口样本的6903名男子（平均年龄51.5岁）谁经历了一个单一的中年评估的一部分，多因素瑞典一级预防研究。在最长34.3年的随访期间，共有1253名男性（18.2%）随后出院诊断为AF（主要或次要）。20岁时的体表面积（BSA）（根据回忆的体重和测量的身高计算）与随后的AF密切相关（P < 0.0001），中年BMI和从20岁到中年的体重增加也是如此（P < 0.0001）。在校正中年BMI、体重增加和其他风险因素的考克斯回归模型中，与最低四分位数相比，20岁时BSA第二、第三和第四分位数的AF风险比（HR）[95%置信区间（CI）]为1.47（95% CI，1.22-1.76），1.66（95% CI，1.38-2.00）和2.22（95% CI，1.82-2.70）（趋势P < 0.0001）。在肥胖罕见的时代，年轻人的体型较大，以及从20岁到中年的体重增加，两者均与AF的发展独立相关。鉴于目前不仅肥胖而且身高的趋势，AF的发病率可能会大幅增加。
Obesity is a recognized risk factor for atrial fibrillation (AF), partly because of the association between body mass index (BMI) and atrial volume. We aimed to determine whether other factors relating to body size were related to AF.Data were derived from a random population sample of 6903 men (mean age 51.5 years) who underwent a single midlife evaluation as part of the multifactor Swedish Primary Prevention Study. A total of 1253 men (18.2%) had a subsequent hospital discharge diagnosis (principal or secondary) of AF during a maximum follow-up of 34.3 years. Body surface area (BSA) at age 20 (calculated from recalled weight and measured height) was strongly related to subsequent AF (P < 0.0001), as were midlife BMI and weight gain from age 20 to midlife (P < 0.0001). In a Cox regression model which adjusted for midlife BMI, weight gain and other risk factors, hazard ratios (HR) [95% confidence intervals (CI)] for AF for the second, third, and fourth quartile of BSA at age 20, compared with the lowest quartile, were 1.47 (95% CI, 1.22-1.76), 1.66 (95% CI, 1.38-2.00), and 2.22 (95% CI, 1.82-2.70) (P for trend < 0.0001).Large body size in youth, in an era when obesity was rare, as well as weight gain from age 20 to midlife, were both independently related to the development of AF. Given the current trends not only for obesity but also for height, a substantial increase in the incidence of AF is likely.