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

Frontiers in Cardiovascular Medicine

article

Maoxiang Zhao¹  Wenjuan Du²  Qianqian Zhao¹  Yating Chen¹  Bin Li¹  Zhonghui Xie¹  Zihao Fu¹  Nan Zhang¹  Xiaowei Cheng¹  Xiaoqian Li³  Siyu Yao¹  Miao Wang⁴  Chi Wang¹  Shouling Wu⁵  Hao Xue⁶  Yang Li¹ 

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

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

DOI  :  10.3389/fcvm.2022.888062

学科分类：地球科学(综合)

来源: Frontiers

【 摘 要 】

Objective Atrial 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. Methods A 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. Results During 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. Conclusion In 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】

CC BY