Lean Body Mass Is the Predominant Anthropometric Risk Factor for Atrial Fibrillation

TY - JOUR

T1 - Lean Body Mass Is the Predominant Anthropometric Risk Factor for Atrial Fibrillation

AU - Fenger-Grøn, Morten

AU - Overvad, Kim

AU - Tjønneland, Anne

AU - Frost, Lars

PY - 2017/5/23

Y1 - 2017/5/23

N2 - Background Obesity is repeatedly emphasized as a risk factor for atrial fibrillation or flutter (AF). However, the underlying evidence may be questioned, as the obvious correlations between various anthropometric measures hamper identification of the characteristics that are biologically driving AF risk, and recent studies suggest that fat carries limited or no independent risk of AF. Objectives This study sought to assess mutually adjusted associations among AF risk and height, weight, body mass index, hip and waist circumference, waist-to-hip ratio, and bioelectrical impedance-derived measures of fat mass, lean body mass, and fat percentage. Methods Anthropometric measures and self-reported life-style information were collected from 1993 to 1997 in a population-based cohort including 55,273 persons age 50 to 64 years who were followed in Danish registers until June 2013. Results During a median of 17 years of follow-up, 3,868 persons developed AF. Adjusted hazard ratios per population SD difference (HRs) showed highly statistically significant, positive associations for all 9 anthropometric measures (HRs ranging from 1.08 [95% confidence interval (CI): 1.05 to 1.12] for waist-to-hip ratio to 1.37 [95% CI: 1.33 to 1.42] for lean body mass). Pairwise mutual adjustment of the 9 measures left the association for lean body mass virtually unchanged (lowest HR: 1.33 [95% CI: 1.28 to 1.39] when adjusting for height), whereas no other association remained substantial when adjusted for lean body mass (highest HR: 1.05 [95% CI: 1.01 to 1.10] for height). Conclusions Lean body mass was the predominant anthropometric risk factor for AF, whereas no association was observed for either of the obesity-related anthropometric measures after adjustment for lean body mass.

AB - Background Obesity is repeatedly emphasized as a risk factor for atrial fibrillation or flutter (AF). However, the underlying evidence may be questioned, as the obvious correlations between various anthropometric measures hamper identification of the characteristics that are biologically driving AF risk, and recent studies suggest that fat carries limited or no independent risk of AF. Objectives This study sought to assess mutually adjusted associations among AF risk and height, weight, body mass index, hip and waist circumference, waist-to-hip ratio, and bioelectrical impedance-derived measures of fat mass, lean body mass, and fat percentage. Methods Anthropometric measures and self-reported life-style information were collected from 1993 to 1997 in a population-based cohort including 55,273 persons age 50 to 64 years who were followed in Danish registers until June 2013. Results During a median of 17 years of follow-up, 3,868 persons developed AF. Adjusted hazard ratios per population SD difference (HRs) showed highly statistically significant, positive associations for all 9 anthropometric measures (HRs ranging from 1.08 [95% confidence interval (CI): 1.05 to 1.12] for waist-to-hip ratio to 1.37 [95% CI: 1.33 to 1.42] for lean body mass). Pairwise mutual adjustment of the 9 measures left the association for lean body mass virtually unchanged (lowest HR: 1.33 [95% CI: 1.28 to 1.39] when adjusting for height), whereas no other association remained substantial when adjusted for lean body mass (highest HR: 1.05 [95% CI: 1.01 to 1.10] for height). Conclusions Lean body mass was the predominant anthropometric risk factor for AF, whereas no association was observed for either of the obesity-related anthropometric measures after adjustment for lean body mass.

KW - anthropometry

KW - cohort

KW - epidemiology

KW - obesity

KW - weight

UR - https://www.scopus.com/pages/publications/85019246728

U2 - 10.1016/j.jacc.2017.03.558

DO - 10.1016/j.jacc.2017.03.558

M3 - Journal article

SN - 0735-1097

VL - 69/20

SP - 2488

EP - 2497

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

IS - 20

M1 - doi: 10.1016/j.jacc.2017.03.558

ER -