Body mass index, abdominal fatness, fat mass and the risk of atrial fibrillation: a systematic review and dose–response meta-analysis of prospective studies

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.Electronic supplementary materialThe online version of this article (doi:10.1007/s10654-017-0232-4) contains supplementary material, which is available to authorized users.

Body mass index, abdominal fatness, weight gain and the risk of urinary incontinence: a systematic review and dose–response meta‐analysis of prospective studies

“…These findings have important clinical and public health implications because of the growing obesity epidemic worldwide, and add to the wide range of adverse health effects that already have been established to be related to excess weight . The current study suggests excess weight is a risk factor for urinary incontinence and underscores the importance of population‐wide policies and initiatives for prevention of overweight and obesity.…”

Improved Exercise Capacity After Cardiac Rehabilitation Is Associated with Reduced Visceral Fat in Patients with Chronic Heart Failure

“…12) In addition, abdominal fat accumulation is a highly prevalent condition in patients with CHF, 13) and epidemiologic studies have shown that the accumulation of abdominal fat contributes to the incidence and severity of CHF. 14,15) It has not previously been shown whether CR changes VAT/SAT volume and skeletal muscle mass in patients with CHF, although several studies have shown that exercise and lifestyle modification reduce VAT in patients with diabetes, hyperlipidemia, and obesity without CHF. [16][17][18] The accumulation of abdominal fat leads to the accumulation of cardiovascular risk factors, including insulin resistance, lipid abnormalities, and abnormalities of muscle metabolism.…”

Sex Differences in the Impact of Body Mass Index on the Risk of Future Atrial Fibrillation: Insights From the Longitudinal Population‐Based Tromsø Study

“…20 Increased risk was also demonstrated with relatively higher BMI, even within the normal BMI range. 20 However, not all included studies took sex into consideration during analysis. The incidence of AF differs between men and women (it is up to 2 times higher in men 21 ) because of the prevalence of major risk factors for AF, including hypertension, diabetes mellitus, coronary artery disease, and heart failure, also differing between the sexes.…”

“…Some have suggested a J‐shaped dose‐response relationship between BMI and AF; however, others have found a linear association . A recent systematic review and dose‐response meta‐analysis of prospective studies demonstrated a nonlinear association between BMI and risk of AF, with a stronger association at higher BMI levels and a 28% increase in the relative risk of AF for every 5 kg/m 2 increase in BMI identified . Increased risk was also demonstrated with relatively higher BMI, even within the normal BMI range .…”

“…A recent systematic review and dose‐response meta‐analysis of prospective studies demonstrated a nonlinear association between BMI and risk of AF, with a stronger association at higher BMI levels and a 28% increase in the relative risk of AF for every 5 kg/m 2 increase in BMI identified . Increased risk was also demonstrated with relatively higher BMI, even within the normal BMI range . However, not all included studies took sex into consideration during analysis.…”