Risk of new-onset atrial fibrillation in relation to body mass index
Risk of new-onset atrial fibrillation in relation to body mass index
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DOI：
10.1001/archinte.166.21.2322
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发表时间：
2006-11-27
影响因子：
--
通讯作者：
Heckbert, Susan R.
中科院分区：
文献类型：
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作者：
Dublin, Sascha;French, Benjamin;Heckbert, Susan R.
背景：肥胖与房颤（AF）风险增加相关，但尚不清楚这种关联是否因房颤持续时间或持续性而异。心血管危险因素在多大程度上介导了这种关联也尚不清楚。方法：这项以人群为基础的病例对照研究包括425名新发房颤患者和707名对照组。房颤病例通过《国际疾病分类》第九版住院和门诊就诊代码进行鉴定，并通过病历复核进行验证。医疗记录提供了有关身高、体重和心血管风险因素的数据。结果：体重指数（BMI）（以体重（公斤）除以身高（米）的平方计算）每增加一个单位，房颤风险平均增加3%（95%置信区间[CI]， 1%-5%）。对于持续性房颤（病程>= 6个月），每单位BMI增加风险增加7% (95% CI, 3%-11%)；对于间歇性房颤（持续时间>= 8天或复发），4% (95% CI, 1%-6%)；短暂性房颤（持续时间< 8天）为1% （95% CI， -1%至+4%）。与BMI正常者相比，超重和肥胖受试者的比值比如下：超重，0.97 (95% CI, 0.68-1.38)；肥胖1级，1.18 (95% CI, 0.80-1.73)；肥胖2级，1.34 (95% CI, 0.82-2.18)；肥胖3级为2.31 (95% CI, 1.36-3.91) （P = 0.002）。当模型中加入可能的中介因素糖尿病时，BMI单位增量的优势比从1.034下降到1.028。调整其他心血管危险因素，包括高脂血症和血压，并没有减弱BMI-AF的关联。结论：与短暂性或间歇性房颤相比，持续性房颤与BMI的相关性更强。肥胖与房颤的关联似乎部分由糖尿病介导，但通过其他心血管危险因素介导的可能性很小。
Background: Obesity is associated with increased risk of atrial fibrillation (AF), but it is unknown whether the association differs by duration or persistence of AF. It is also unknown to what extent cardiovascular risk factors may mediate this association.Methods: This population-based case-control study included 425 subjects with new-onset AF and 707 controls. The AF cases were identified through International Classification of Diseases, Ninth Revision codes for inpatient and outpatient visits and verified by medical record review. Medical records provided data on height, weight, and cardiovascular risk factors.Results: On average, AF risk was 3% higher (95% confidence interval [CI], 1%-5%) per unit increment in body mass index (BMI) ( calculated as weight in kilograms divided by height in meters squared). For sustained AF ( duration >= 6 months), risk was higher by 7% (95% CI, 3%-11%) per unit BMI increment; for intermittent AF ( duration >= 8 days or recurrent), 4% ( 95% CI, 1%-6%); and for transitory AF ( duration < 8 days), 1% ( 95% CI, -1% to +4%). Compared with those with normal BMI, the odds ratios for overweight and obese subjects were as follows: overweight, 0.97 ( 95% CI, 0.68-1.38); obese class 1,1.18 ( 95% CI, 0.80-1.73); obese class 2, 1.34 ( 95% CI, 0.82-2.18); and obese class 3, 2.31 ( 95% CI, 1.36-3.91) (P = .002 for trend). When diabetes mellitus, a possible mediator, was added to the model, the odds ratio per unit increment of BMI decreased from 1.034 to 1.028. Adjustment for other cardiovascular risk factors including hyperlipidemia and blood pressure did not attenuate the BMI-AF association.Conclusions: The association with BMI was stronger for sustained AF than for transitory or intermittent AF. The obesity-AF association appears to be partially mediated by diabetes mellitus but minimally through other cardiovascular risk factors.