Transition of Metabolic Phenotypes and Risk of Atrial Fibrillation According to BMI: Kailuan Study

Frontiers in Cardiovascular Medicine

Xiaowei Cheng¹  Qianqian Zhao¹  Zhonghui Xie¹  Bin Li¹  Yating Chen¹  Chi Wang¹  Siyu Yao¹  Yang Li¹  Maoxiang Zhao¹  Zihao Fu¹  Nan Zhang¹  Xiaoqian Li²  Shouling Wu³  Hao Xue⁴  Wenjuan Du⁵  Miao Wang⁶ 

[1] Department of Cardiology, First Medical Center, Chinese People’s Liberation Army Hospital, Medical School of Chinese People’s Liberation Army, Beijing, China;Department of Cardiology, Fujian Medical University, Fuzhou, China;Department of Cardiology, Kailuan Hospital, Tangshan, China;Department of Cardiology, Sixth Medical Center, Chinese People’s Liberation Army Hospital, Medical School of Chinese People’s Liberation Army, Beijing, China;Laboratory of Radiation Injury Treatment, Medical Innovation Research Division, PLA General Hospital, Beijing, China;School of Medicine, Nankai University, Tianjin, China;

关键词: atrial fibrillation;    obesity;    metabolic health;    transition;    body mass index;   

DOI  :  10.3389/fcvm.2022.888062

来源: DOAJ

【 摘 要 】

ObjectiveAtrial fibrillation (AF) is associated with both obesity and its metabolic consequences. However, there is a paucity of information on whether the dynamic change of metabolic health and obesity phenotypes affect the risk of AF. We aimed to prospectively examine the association between metabolic health and its change over time and AF risk across body mass index (BMI) categories.MethodsA total of 58,483 participants without history of cancer, and cardiovascular diseases from the Kailuan study were included in the present study. Transition of metabolic phenotypes was evaluated between 1st survey (2006–2007) and the 2nd survey (2008–2009). The hazard ratios (HRs) and 95% confidence intervals (CIs) for AF were assessed by Cox proportional hazards regression.ResultsDuring a median follow-up of 3 years, we documented 580 cases of AF. Compared with metabolically healthy individuals with normal weight, the multivariable-adjusted hazard ratios for metabolically healthy and unhealthy overweight/obese were 1.27 (95% CI: 1.01, 1.59) and 1.37 (95% CI: 1.09, 1.72), respectively. However, when transition was taken into account, overweight/obese people who maintained metabolically healthy status were not associated with increased long-term risk (HR, 1.11;95% CI: 0.70, 1.78), whereas participants who converted from metabolically healthy overweight/obese status to an unhealthy phenotype had higher AF risk than those who maintained metabolically healthy normal weight (HR 1.59, 95% CI: 1.11, 2.26). When BMI and metabolically healthy status were updated over the course of the study, significant short-term elevations in AF risk were associated with individuals with stable MU-OW/OB status.ConclusionIn this community-based cohort study, metabolically healthy overweight/obese individuals have increased risks of AF. Obesity remains a risk factor for AF independent of major metabolic factors. Our data further suggested that metabolic phenotype was a dynamic condition, and maintenance of metabolic health and normal weight might alleviate the risk of AF.

【 授权许可】

Unknown