Underweight is a risk factor for atrial fibrillation: A nationwide population-based study

医学 心房颤动 体重不足 风险因素 内科学 心脏病学 人口 肥胖 环境卫生 超重
作者
Si–Hyuck Kang,Eue‐Keun Choi,Kyungdo Han,So‐Ryoung Lee,Woo‐Hyun Lim,Myung‐Jin Cha,Youngjin Cho,Il‐Young Oh,Seil Oh
出处
期刊:International Journal of Cardiology [Elsevier BV]
卷期号:215: 449-456 被引量:105
标识
DOI:10.1016/j.ijcard.2016.04.036
摘要

Background Obesity is a well-known risk factor for development of atrial fibrillation (AF). However, the impact of underweight on AF has not been previously recognized. We sought to determine the risk of AF in subjects with underweight in this study. Methods We analyzed clinical data from a total of 132,063 individuals with the age of 40 years or older who received health care checkups arranged by the national insurance program between 2003 and 2004. Newly diagnosed nonvalvular AF was identified using claim data during a median follow-up duration of 9.0 years. Results The mean body mass index (BMI) of patients was 23.9 kg/m2, and 3,323 individuals (2.5%) were classified as being underweight (BMI <18.5 kg/m2). During the study period, 3,237 individuals (2.5%) developed AF. There was a U-shaped relationship between BMI and AF occurrence: Each 1.0 kg/m2 increase of BMI above 20 kg/m2 was associated with a 6% increased risk of AF (p < 0.001), while each 1.0 kg/m2 lower BMI below 20 kg/m2 was associated with a 13% increased risk of AF (p < 0.001) after multivariable adjustment. Underweight was significantly associated with 23% increased risk of AF, while obesity classes I and II were with 26% and 120% increased risk of AF, respectively. Excess risk of AF in the underweight was independent of thyroid disease, chronic lung disease, or history of malignancy, and was not attributable to cigarette smoking, low socioeconomic status, excessive physical activity, or heavy alcohol consumption. Conclusion BMI has a U-shaped relationship with the risk of AF. Underweight was an independent risk factor for AF independent of confounding factors such as chronic lung disease and malignancy. These findings suggest that underweight is associated with biological effects that contribute to the development of AF.

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