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Body mass index, abdominal fatness, fat mass and the risk of atrial fibrillation: a systematic review and dose-response meta-analysis of prospective studies.
Eur J Epidemiol 2017; 32(3):181-192EJ

Abstract

Different adiposity measures have been associated with increased risk of atrial fibrillation, however, results have previously only been summarized for BMI. We therefore conducted a systematic review and meta-analysis of prospective studies to clarify the association between different adiposity measures and risk of atrial fibrillation. PubMed and Embase databases were searched up to October 24th 2016. Summary relative risks (RRs) were calculated using random effects models. Twenty-nine unique prospective studies (32 publications) were included. Twenty-five studies (83,006 cases, 2,405,381 participants) were included in the analysis of BMI and atrial fibrillation. The summary RR was 1.28 (95% confidence interval: 1.20-1.38, I2 = 97%) per 5 unit increment in BMI, 1.18 (95% CI: 1.12-1.25, I2 = 73%, n = 5) and 1.32 (95% CI: 1.16-1.51, I2 = 91%, n = 3) per 10 cm increase in waist and hip circumference, respectively, 1.09 (95% CI: 1.02-1.16, I2 = 44%, n = 4) per 0.1 unit increase in waist-to-hip ratio, 1.09 (95% CI: 1.02-1.16, I2 = 94%, n = 4) per 5 kg increase in fat mass, 1.10 (95% CI: 0.92-1.33, I2 = 90%, n = 3) per 10% increase in fat percentage, 1.10 (95% CI: 1.08-1.13, I2 = 74%, n = 10) per 5 kg increase in weight, and 1.08 (95% CI: 0.97-1.19, I2 = 86%, n = 2) per 5% increase in weight gain. The association between BMI and atrial fibrillation was nonlinear, p nonlinearity < 0.0001, with a stronger association at higher BMI levels, however, increased risk was observed even at a BMI of 22-24 compared to 20. In conclusion, general and abdominal adiposity and higher body fat mass increase the risk of atrial fibrillation.

Authors+Show Affiliations

Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway. d.aune@imperial.ac.uk. Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, Paddington, London, W2 1PG, UK. d.aune@imperial.ac.uk. Bjørknes University College, Oslo, Norway. d.aune@imperial.ac.uk.Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, Paddington, London, W2 1PG, UK.Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, Paddington, London, W2 1PG, UK.Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.Department of Preventive Cardiology, Oslo University Hospital Ullevål, Oslo, Norway.Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, Paddington, London, W2 1PG, UK.Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

28194602

Citation

Aune, Dagfinn, et al. "Body Mass Index, Abdominal Fatness, Fat Mass and the Risk of Atrial Fibrillation: a Systematic Review and Dose-response Meta-analysis of Prospective Studies." European Journal of Epidemiology, vol. 32, no. 3, 2017, pp. 181-192.
Aune D, Sen A, Schlesinger S, et al. Body mass index, abdominal fatness, fat mass and the risk of atrial fibrillation: a systematic review and dose-response meta-analysis of prospective studies. Eur J Epidemiol. 2017;32(3):181-192.
Aune, D., Sen, A., Schlesinger, S., Norat, T., Janszky, I., Romundstad, P., ... Vatten, L. J. (2017). Body mass index, abdominal fatness, fat mass and the risk of atrial fibrillation: a systematic review and dose-response meta-analysis of prospective studies. European Journal of Epidemiology, 32(3), pp. 181-192. doi:10.1007/s10654-017-0232-4.
Aune D, et al. Body Mass Index, Abdominal Fatness, Fat Mass and the Risk of Atrial Fibrillation: a Systematic Review and Dose-response Meta-analysis of Prospective Studies. Eur J Epidemiol. 2017;32(3):181-192. PubMed PMID: 28194602.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Body mass index, abdominal fatness, fat mass and the risk of atrial fibrillation: a systematic review and dose-response meta-analysis of prospective studies. AU - Aune,Dagfinn, AU - Sen,Abhijit, AU - Schlesinger,Sabrina, AU - Norat,Teresa, AU - Janszky,Imre, AU - Romundstad,Pål, AU - Tonstad,Serena, AU - Riboli,Elio, AU - Vatten,Lars J, Y1 - 2017/02/13/ PY - 2016/11/22/received PY - 2017/02/01/accepted PY - 2017/2/15/pubmed PY - 2018/2/14/medline PY - 2017/2/15/entrez KW - Atrial fibrillation KW - BMI KW - Fat mass KW - Fat percentage KW - Hip circumference KW - Meta-analysis KW - Obesity KW - Waist circumference KW - Waist-to-hip ratio SP - 181 EP - 192 JF - European journal of epidemiology JO - Eur. J. Epidemiol. VL - 32 IS - 3 N2 - Different adiposity measures have been associated with increased risk of atrial fibrillation, however, results have previously only been summarized for BMI. We therefore conducted a systematic review and meta-analysis of prospective studies to clarify the association between different adiposity measures and risk of atrial fibrillation. PubMed and Embase databases were searched up to October 24th 2016. Summary relative risks (RRs) were calculated using random effects models. Twenty-nine unique prospective studies (32 publications) were included. Twenty-five studies (83,006 cases, 2,405,381 participants) were included in the analysis of BMI and atrial fibrillation. The summary RR was 1.28 (95% confidence interval: 1.20-1.38, I2 = 97%) per 5 unit increment in BMI, 1.18 (95% CI: 1.12-1.25, I2 = 73%, n = 5) and 1.32 (95% CI: 1.16-1.51, I2 = 91%, n = 3) per 10 cm increase in waist and hip circumference, respectively, 1.09 (95% CI: 1.02-1.16, I2 = 44%, n = 4) per 0.1 unit increase in waist-to-hip ratio, 1.09 (95% CI: 1.02-1.16, I2 = 94%, n = 4) per 5 kg increase in fat mass, 1.10 (95% CI: 0.92-1.33, I2 = 90%, n = 3) per 10% increase in fat percentage, 1.10 (95% CI: 1.08-1.13, I2 = 74%, n = 10) per 5 kg increase in weight, and 1.08 (95% CI: 0.97-1.19, I2 = 86%, n = 2) per 5% increase in weight gain. The association between BMI and atrial fibrillation was nonlinear, p nonlinearity < 0.0001, with a stronger association at higher BMI levels, however, increased risk was observed even at a BMI of 22-24 compared to 20. In conclusion, general and abdominal adiposity and higher body fat mass increase the risk of atrial fibrillation. SN - 1573-7284 UR - https://www.unboundmedicine.com/medline/citation/28194602/Body_mass_index_abdominal_fatness_fat_mass_and_the_risk_of_atrial_fibrillation:_a_systematic_review_and_dose_response_meta_analysis_of_prospective_studies_ L2 - https://doi.org/10.1007/s10654-017-0232-4 DB - PRIME DP - Unbound Medicine ER -