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Body mass index, abdominal fatness, and the risk of sudden cardiac death: a systematic review and dose-response meta-analysis of prospective studies.
Eur J Epidemiol 2018; 33(8):711-722EJ

Abstract

Although overweight and obesity are established risk factors for some types of heart disease including ischemic heart disease, heart failure and atrial fibrillation, less is known about the association between adiposity and sudden cardiac death. We conducted a systematic review and meta-analysis of prospective studies to clarify the association between adiposity and risk of sudden cardiac death. PubMed and Embase databases were searched up to July 20th 2017. Summary relative risks (RRs) and 95% confidence intervals (CIs) were calculated using random effects models. The summary RR was 1.16 (95% CI 1.05-1.28, I2 = 68%, n = 14) per 5 unit increment in BMI, and 1.82 (95% CI 1.61-2.07, I2 = 0%, n = 3) per 0.1 unit increase in waist-to-hip ratio, and 1.03 (95% CI 0.93-1.15, I2 = 0%, n = 2) per 10 cm increase in waist circumference. The heterogeneity in the analysis of BMI and sudden cardiac death persisted across most subgroup analyses. The association was stronger among studies with longer follow-up compared to short follow-up and was observed in the European and American studies, but not in the Asian studies. There was a J-shaped association between BMI and sudden cardiac death and the lowest risk was observed in the normal weight range, however, the increased risk with a low BMI was attenuated among studies with a longer duration of follow-up. This meta-analysis suggest an increased risk of sudden cardiac death with increasing BMI and waist-to-hip ratio, however, further studies with stratification for smoking status are needed of waist circumference, weight changes and adiposity at younger ages.

Authors+Show Affiliations

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 Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway. d.aune@imperial.ac.uk.Institute for Biometrics and Epidemiology, German Diabetes Center (DDZ), Heinrich Heine University Düsseldorf, Düsseldorf, Germany.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.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

29417316

Citation

Aune, Dagfinn, et al. "Body Mass Index, Abdominal Fatness, and the Risk of Sudden Cardiac Death: a Systematic Review and Dose-response Meta-analysis of Prospective Studies." European Journal of Epidemiology, vol. 33, no. 8, 2018, pp. 711-722.
Aune D, Schlesinger S, Norat T, et al. Body mass index, abdominal fatness, and the risk of sudden cardiac death: a systematic review and dose-response meta-analysis of prospective studies. Eur J Epidemiol. 2018;33(8):711-722.
Aune, D., Schlesinger, S., Norat, T., & Riboli, E. (2018). Body mass index, abdominal fatness, and the risk of sudden cardiac death: a systematic review and dose-response meta-analysis of prospective studies. European Journal of Epidemiology, 33(8), pp. 711-722. doi:10.1007/s10654-017-0353-9.
Aune D, et al. Body Mass Index, Abdominal Fatness, and the Risk of Sudden Cardiac Death: a Systematic Review and Dose-response Meta-analysis of Prospective Studies. Eur J Epidemiol. 2018;33(8):711-722. PubMed PMID: 29417316.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Body mass index, abdominal fatness, and the risk of sudden cardiac death: a systematic review and dose-response meta-analysis of prospective studies. AU - Aune,Dagfinn, AU - Schlesinger,Sabrina, AU - Norat,Teresa, AU - Riboli,Elio, Y1 - 2018/02/07/ PY - 2017/08/10/received PY - 2017/12/26/accepted PY - 2018/2/9/pubmed PY - 2019/7/17/medline PY - 2018/2/9/entrez KW - BMI KW - Meta-analysis KW - Obesity KW - Sudden cardiac death KW - Waist-to-hip ratio SP - 711 EP - 722 JF - European journal of epidemiology JO - Eur. J. Epidemiol. VL - 33 IS - 8 N2 - Although overweight and obesity are established risk factors for some types of heart disease including ischemic heart disease, heart failure and atrial fibrillation, less is known about the association between adiposity and sudden cardiac death. We conducted a systematic review and meta-analysis of prospective studies to clarify the association between adiposity and risk of sudden cardiac death. PubMed and Embase databases were searched up to July 20th 2017. Summary relative risks (RRs) and 95% confidence intervals (CIs) were calculated using random effects models. The summary RR was 1.16 (95% CI 1.05-1.28, I2 = 68%, n = 14) per 5 unit increment in BMI, and 1.82 (95% CI 1.61-2.07, I2 = 0%, n = 3) per 0.1 unit increase in waist-to-hip ratio, and 1.03 (95% CI 0.93-1.15, I2 = 0%, n = 2) per 10 cm increase in waist circumference. The heterogeneity in the analysis of BMI and sudden cardiac death persisted across most subgroup analyses. The association was stronger among studies with longer follow-up compared to short follow-up and was observed in the European and American studies, but not in the Asian studies. There was a J-shaped association between BMI and sudden cardiac death and the lowest risk was observed in the normal weight range, however, the increased risk with a low BMI was attenuated among studies with a longer duration of follow-up. This meta-analysis suggest an increased risk of sudden cardiac death with increasing BMI and waist-to-hip ratio, however, further studies with stratification for smoking status are needed of waist circumference, weight changes and adiposity at younger ages. SN - 1573-7284 UR - https://www.unboundmedicine.com/medline/citation/29417316/Body_mass_index_abdominal_fatness_and_the_risk_of_sudden_cardiac_death:_a_systematic_review_and_dose_response_meta_analysis_of_prospective_studies_ L2 - https://doi.org/10.1007/s10654-017-0353-9 DB - PRIME DP - Unbound Medicine ER -