Body mass index and body fat distribution and new-onset atrial fibrillation: Substudy of the European Prospective Investigation into Cancer and Nutrition in Norfolk (EPIC-Norfolk) study |
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| Institution: | 1. Department of Cardiology, Heart Center, Academic Medical Center, Amsterdam, the Netherlands;2. Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom;3. Department III of Internal Medicine, Heart Centre of the University of Cologne, Germany;4. MRC Epidemiology Unit, Cambridge, United Kingdom;5. Centre for Heart Rhythm Disorders (CHRD), South Australian Health and Medical Research Institute (SAHMRI), University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia;1. Division of Gastroenterology and Hepatology and Division of Clinical Pathology, University Hospital, Geneva, Switzerland;2. Department of Gastroenterology and Hepatology, St George’s Hospital, London, England;3. Gastroenterology and Internal Medicine, University of Palermo, Palermo, Italy;4. Johns Hopkins University School of Medicine, Baltimore, Maryland;5. Toronto Centre for Liver Disease, Sandra Rotman Centre for Global Health, University of Toronto, Toronto, Ontario, Canada;6. Department of Gastroenterology, Hepatology and Endocrinology, Medical School of Hannover, Hannover, Germany;1. Institute of Nutrition and Functional Foods (INAF), Université Laval, Quebec, G1V 0A6, Canada;2. School of Nutrition, Université Laval, Quebec, G1V 0A6, Canada;3. Department of Family Medicine, Université de Sherbrooke, Sherbrooke, QC, J1H 5N4, Canada;4. Montreal Clinical Research Institute, Université de Montréal, Montréal, QC, H2W 1R7, Canada;5. ECOGENE-21 Biocluster, Chicoutimi, Qc, G7H 7K9, Canada;6. Faculté de médecine et des Sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, J1H 5N4, Canada;7. Département des Sciences infirmières, Université du Québec à Trois-Rivières, Trois-Rivières, QC, G9A 5H7, Canada |
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| Abstract: | Background and aimObesity is a recognized risk factor for new-onset atrial fibrillation (AF). The association between body fat distribution, which is measured by body mass index (BMI) and waist–hip ratio (WHR), its changes, and new-onset AF is conflicting.Methods and resultsParticipants of the European Prospective Investigation into Cancer and Nutrition in Norfolk cohort study were included, with exclusion criteria of prevalent AF, rheumatic heart disease, and cancer. AF was confirmed by the International Classification of Diseases-10 hospital discharge code I48. Adjusted sex-specific Cox proportional hazards models were used to quantify the AF risk per 1 standard deviation increase and for quintiles of adiposity indices. A total of 10,885 men and 12,857 women were followed up for a median of 19 years, yielding 451,098 person-years. New-onset AF was diagnosed in 1408 (12.9%) men and 1102 (8.6%) women. Multivariable analyses showed that BMI predicted new-onset AF in all, while WHR predicted only in men. New-onset AF risk gradually increased across the range of adiposity indices: for men in the highest BMI quintile, HR: 1.59 (CI 1.32–1.91, p for trend<0.001), whereas for women in the highest BMI quintile, HR: 1.52 (CI 1.23–1.88, p for trend<0.001). Further, for men in the highest WHR quintile, HR: 1.31 (CI 1.09–1.57, p for trend: 0.01), whereas for women in the highest WHR quintile, HR: 1.12 (CI 0.90–1.41, p for trend: 0.17). The change in BMI and WHR was similar in participants with or without new-onset AF.ConclusionsAn increased body mass, as measured by BMI, is associated with an increased risk of developing new-onset AF. More abdominal fat distribution, as measured by WHR, is associated with an increased risk of developing new-onset AF in men but not in women. |
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| Keywords: | Abdominal fat Body mass index Visceral fat Waist–hip ratio Atrial arrhythmia |
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