TY - JOUR
T1 - Joint Associations Between Body Mass Index and Waist Circumference With Atrial Fibrillation in Men and Women
AU - Poorthuis, Michiel H F
AU - Sherliker, Paul
AU - de Borst, Gert J
AU - Carter, Jennifer L
AU - Lam, Kin Bong Hubert
AU - Jones, Nicholas R
AU - Halliday, Alison
AU - Lewington, Sarah
AU - Bulbulia, Richard
N1 - Funding Information:
Nicholas R Jones reports support from a Wellcome Trust Doctoral Research Fellowship grant (grant number 203921/Z/16/Z). Sarah Lewington reports grants from UK Medical Research Council during the conduct of the study; grants from CDC Foundation outside the submitted work. Richard Bulbulia reports grants from UK Medical Research Council during the conduct of the study; grants from UK Medical Research Council outside the submitted work. Alison Halliday is funded by the UK Health Research (NIHR) Oxford Biomedical Research Centre (BRC). The remaining authors have no disclosures to report.
Funding Information:
Professor Halliday is funded by the UK Health Research (NIHR) Oxford Biomedical Research Centre (BRC). Sarah Lewington is funded by the UK Medical Research Council and the CDC foundation (with support from Amgen). The study funders had no role in study design; data collection, analysis, or interpretation; or drafting of the report. The corresponding author had full access to all data in the study and had final responsibility for the decision to publish the report.
Publisher Copyright:
© 2021 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
PY - 2021/4/20
Y1 - 2021/4/20
N2 - Background Associations between adiposity and atrial fibrillation (AF) might differ between sexes. We aimed to determine precise estimates of the risk of AF by body mass index (BMI) and waist circumference (WC) in men and women. Methods and Results Between 2008 and 2013, over 3.2 million adults attended commercial screening clinics. Participants completed health questionnaires and underwent physical examination along with cardiovascular investigations, including an ECG. We excluded those with cardiovascular and cardiac disease. We used multivariable logistic regression and determined joint associations of BMI and WC and the risk of AF in men and women by comparing likelihood ratio χ2 statistics. Among 2.1 million included participants 12 067 (0.6%) had AF. A positive association between BMI per 5 kg/m2 increment and AF was observed, with an odds ratio of 1.65 (95% CI, 1.57-1.73) for men and 1.36 (95% CI, 1.30-1.42) for women among those with a BMI above 20 kg/m2. We found a positive association between AF and WC per 10 cm increment, with an odds ratio of 1.47 (95% CI, 1.36-1.60) for men and 1.37 (95% CI, 1.26-1.49) for women. Improvement of likelihood ratio χ2 was equal after adding BMI and WC to models with all participants. In men, WC showed stronger improvement of likelihood ratio χ2 than BMI (30% versus 23%). In women, BMI showed stronger improvement of likelihood ratio χ2 than WC (23% versus 12%). Conclusions We found a positive association between BMI (above 20 kg/m2) and AF and between WC and AF in both men and women. BMI seems a more informative measure about risk of AF in women and WC seems more informative in men.
AB - Background Associations between adiposity and atrial fibrillation (AF) might differ between sexes. We aimed to determine precise estimates of the risk of AF by body mass index (BMI) and waist circumference (WC) in men and women. Methods and Results Between 2008 and 2013, over 3.2 million adults attended commercial screening clinics. Participants completed health questionnaires and underwent physical examination along with cardiovascular investigations, including an ECG. We excluded those with cardiovascular and cardiac disease. We used multivariable logistic regression and determined joint associations of BMI and WC and the risk of AF in men and women by comparing likelihood ratio χ2 statistics. Among 2.1 million included participants 12 067 (0.6%) had AF. A positive association between BMI per 5 kg/m2 increment and AF was observed, with an odds ratio of 1.65 (95% CI, 1.57-1.73) for men and 1.36 (95% CI, 1.30-1.42) for women among those with a BMI above 20 kg/m2. We found a positive association between AF and WC per 10 cm increment, with an odds ratio of 1.47 (95% CI, 1.36-1.60) for men and 1.37 (95% CI, 1.26-1.49) for women. Improvement of likelihood ratio χ2 was equal after adding BMI and WC to models with all participants. In men, WC showed stronger improvement of likelihood ratio χ2 than BMI (30% versus 23%). In women, BMI showed stronger improvement of likelihood ratio χ2 than WC (23% versus 12%). Conclusions We found a positive association between BMI (above 20 kg/m2) and AF and between WC and AF in both men and women. BMI seems a more informative measure about risk of AF in women and WC seems more informative in men.
KW - Adiposity
KW - Atrial fibrillation
KW - Body mass index
KW - Sex-specific risk factors
KW - Waist circumference
UR - http://www.scopus.com/inward/record.url?scp=85105180602&partnerID=8YFLogxK
U2 - 10.1161/JAHA.120.019025
DO - 10.1161/JAHA.120.019025
M3 - Article
C2 - 33853362
SN - 2047-9980
VL - 10
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 8
M1 - e019025
ER -