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Eur Heart J. 2016 May 21;37(20):1606-13. doi: 10.1093/eurheartj/ehv423. Epub 2015 Sep 14.

Lean body mass and risk of incident atrial fibrillation in post-menopausal women.

Author information

1
Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
2
Department of Medicine, Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA.
3
Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
4
Department of Medicine, University of Arizona, Tucson, AZ, USA.
5
Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, USA.
6
Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, USA.
7
Data Coordinating Center, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
8
Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA.
9
Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA Department of Medicine, Division of Cardiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
10
Department of Biochemistry and Molecular Medicine, University of California Davis, Davis, CA, USA.
11
School of Medicine and Health Sciences, George Washington University, Washington, DC, USA.
12
Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA Stanford Center for Inherited Cardiovascular Disease, 300 Pasteur Drive #H2155, Stanford, CA 94305, USA mvperez@stanford.edu.

Abstract

AIMS:

High body mass index (BMI) is a risk factor for atrial fibrillation (AF). The aim of this study was to determine whether lean body mass (LBM) predicts AF.

METHODS AND RESULTS:

The Women's Health Initiative is a study of post-menopausal women aged 50-79 enrolled at 40 US centres from 1994 to 1998. A subset of 11 393 participants at three centres underwent dual-energy X-ray absorptiometry. Baseline demographics and clinical histories were recorded. Incident AF was identified using hospitalization records and diagnostic codes from Medicare claims. A multivariable Cox hazard regression model adjusted for demographic and clinical risk factors was used to evaluate associations between components of body composition and AF risk. After exclusion for prevalent AF or incomplete data, 8832 participants with an average age of 63.3 years remained for analysis. Over the 11.6 years of average follow-up time, 1035 women developed incident AF. After covariate adjustment, all measures of LBM were independently associated with higher rates of AF: total LBM [hazard ratio (HR) 1.24 per 5 kg increase, 95% confidence intervals (CI) 1.14-1.34], central LBM (HR 1.51 per 5 kg increase, 95% CI 1.31-1.74), and peripheral LBM (HR 1.39 per 5 kg increase, 95% CI 1.19-1.63). The association between total LBM and AF remained significant after adjustment for total fat mass (HR 1.22 per 5 kg increase, 95% CI 1.13-1.31).

CONCLUSION:

Greater LBM is a strong independent risk factor for AF. After adjusting for obesity-related risk factors, the risk of AF conferred by higher BMI is primarily driven by the association between LBM and AF.

KEYWORDS:

Arrhythmia; Atrial fibrillation; Epidemiology

PMID:
26371115
PMCID:
PMC4875559
DOI:
10.1093/eurheartj/ehv423
[Indexed for MEDLINE]
Free PMC Article

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