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Independent effects of adiposity measures on risk of atrial fibrillation in men and women: a study of 0.5M individuals

Abstract:

Background: Atrial fibrillation (AF) has a higher prevalence in men than women and is associated with measures of adiposity and lean mass (LM). However, it remains uncertain if the risks of AF associated with these measures vary by sex.

Methods: Among 477,904 UK Biobank participants aged 40-69 without prior AF, 23,134 incident AF cases were identified (14,400 men, 8,734 women; median follow-up 11.1 years). Cox proportional hazards models were used to estimate covariate adjusted hazard ratios (HR) describing the association of AF with weight, measures of adiposity (fat mass [FM], waist circumference [WC]), and LM and their independent relevance, by sex.

Results: Weight and WC were independently associated with risk of AF (HR:1.25 [1.23-1.27] per-10kg, HR:1.11 [1.09-1.14] per-10cm respectively), with comparable effects in both sexes. The association with weight was principally driven by LM which, per-5kg, conferred double the risk of AF compared to FM when mutually adjusted (HR:1.20 [1.19-1.21], HR:1.10 [1.09-1.11] respectively); however, the effect of LM was weaker in men than women (pinteraction=4.3x10-9). Comparing the relative effects of LM, FM and WC identified different patterns within each sex; LM was the strongest predictor for both, whereas WC was stronger than FM in men but not women.

Conclusions: LM and FM (as constituents of weight), and WC are risk factors for AF. However, the independent relevance of general adiposity for AF was more limited in men than women. The relevance of both WC and LM suggest a potentially important role for visceral adiposity and muscle mass in AF development.

Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1093/ije/dyab184

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Publisher:
Oxford University Press
Journal:
International Journal of Epidemiology More from this journal
Volume:
51
Issue:
3
Pages:
984–995
Publication date:
2021-09-25
Acceptance date:
2021-07-16
DOI:
EISSN:
1464-3685
ISSN:
0300-5771


Language:
English
Keywords:
Pubs id:
1193985
Local pid:
pubs:1193985
Deposit date:
2021-09-14
ARK identifier:

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