Body Mass Index Variability and Long-term Risk of New-Onset Atrial Fibrillation in the General Population

A Korean Nationwide Cohort Study

Yeong Min Lim, Pil Sung Yang, Eunsun Jang, Hee Tae Yu, Tae Hoon Kim, Jae Sun Uhm, Jong Youn Kim, huinam pak, Moon Hyoung Lee, Boyoung Joung, Gregory Y.H. Lip

Research output: Contribution to journalArticle

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Abstract

Objective: To assess the effects of body mass index (BMI) variability on the incidence of new-onset atrial fibrillation (AF), stroke, cardiovascular (CV) risk factors, and CV outcomes in a general Asian population. Patients and Methods: Data from the National Health Insurance Service–Health Screening cohort in Korea were used: 171,324 patients without AF were included, and BMI measurements occurred biennially from January 1, 2002, through December 31, 2009. Patient outcomes were followed through 2013. The BMI intraindividual variability between visits was measured. Results: During mean ± SD follow-up of 47.4±3.9 months, 1959 patients (1.1%) developed new-onset AF. Overweight or obesity (BMI ≥25) had a greater risk of new-onset AF compared with BMI of 20 to 22.5, with a hazard ratio (HR) of 1.24 (95% CI, 1.10-1.41; P<.001). In underweight or normal-weight participants (initial BMI <25), a 1-kg/m2 increase of BMI variability increased the risk of new-onset AF, with an adjusted HR (aHR) of 1.13 (95% CI, 1.01-1.25; P=.02). Weight gain increased the risk of new-onset AF (aHR, 1.32; 95% CI, 1.01-1.71; P=.04) and myocardial infarction (aHR, 1.52; 95% CI, 1.06-2.18; P=.02) but not stroke. In this group, blood pressure, glucose level, and total cholesterol level were higher in individuals with the greatest BMI variability compared with those with stable BMI. Conclusion: In the underweight and normal-weight Asian population, BMI variability, especially weight gain, was related to increased risk of new-onset AF and myocardial infarction. Avoiding weight gain is important to improve CV outcomes.

Original languageEnglish
Pages (from-to)225-235
Number of pages11
JournalMayo Clinic Proceedings
Volume94
Issue number2
DOIs
Publication statusPublished - 2019 Feb 1

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Atrial Fibrillation
Body Mass Index
Cohort Studies
Population
Weight Gain
Thinness
Myocardial Infarction
Weights and Measures
National Health Programs
Korea
Hypercholesterolemia
Blood Glucose
Obesity
Stroke
Blood Pressure
Incidence

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Lim, Yeong Min ; Yang, Pil Sung ; Jang, Eunsun ; Yu, Hee Tae ; Kim, Tae Hoon ; Uhm, Jae Sun ; Kim, Jong Youn ; pak, huinam ; Lee, Moon Hyoung ; Joung, Boyoung ; Lip, Gregory Y.H. / Body Mass Index Variability and Long-term Risk of New-Onset Atrial Fibrillation in the General Population : A Korean Nationwide Cohort Study. In: Mayo Clinic Proceedings. 2019 ; Vol. 94, No. 2. pp. 225-235.
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abstract = "Objective: To assess the effects of body mass index (BMI) variability on the incidence of new-onset atrial fibrillation (AF), stroke, cardiovascular (CV) risk factors, and CV outcomes in a general Asian population. Patients and Methods: Data from the National Health Insurance Service–Health Screening cohort in Korea were used: 171,324 patients without AF were included, and BMI measurements occurred biennially from January 1, 2002, through December 31, 2009. Patient outcomes were followed through 2013. The BMI intraindividual variability between visits was measured. Results: During mean ± SD follow-up of 47.4±3.9 months, 1959 patients (1.1{\%}) developed new-onset AF. Overweight or obesity (BMI ≥25) had a greater risk of new-onset AF compared with BMI of 20 to 22.5, with a hazard ratio (HR) of 1.24 (95{\%} CI, 1.10-1.41; P<.001). In underweight or normal-weight participants (initial BMI <25), a 1-kg/m2 increase of BMI variability increased the risk of new-onset AF, with an adjusted HR (aHR) of 1.13 (95{\%} CI, 1.01-1.25; P=.02). Weight gain increased the risk of new-onset AF (aHR, 1.32; 95{\%} CI, 1.01-1.71; P=.04) and myocardial infarction (aHR, 1.52; 95{\%} CI, 1.06-2.18; P=.02) but not stroke. In this group, blood pressure, glucose level, and total cholesterol level were higher in individuals with the greatest BMI variability compared with those with stable BMI. Conclusion: In the underweight and normal-weight Asian population, BMI variability, especially weight gain, was related to increased risk of new-onset AF and myocardial infarction. Avoiding weight gain is important to improve CV outcomes.",
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Body Mass Index Variability and Long-term Risk of New-Onset Atrial Fibrillation in the General Population : A Korean Nationwide Cohort Study. / Lim, Yeong Min; Yang, Pil Sung; Jang, Eunsun; Yu, Hee Tae; Kim, Tae Hoon; Uhm, Jae Sun; Kim, Jong Youn; pak, huinam; Lee, Moon Hyoung; Joung, Boyoung; Lip, Gregory Y.H.

In: Mayo Clinic Proceedings, Vol. 94, No. 2, 01.02.2019, p. 225-235.

Research output: Contribution to journalArticle

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T1 - Body Mass Index Variability and Long-term Risk of New-Onset Atrial Fibrillation in the General Population

T2 - A Korean Nationwide Cohort Study

AU - Lim, Yeong Min

AU - Yang, Pil Sung

AU - Jang, Eunsun

AU - Yu, Hee Tae

AU - Kim, Tae Hoon

AU - Uhm, Jae Sun

AU - Kim, Jong Youn

AU - pak, huinam

AU - Lee, Moon Hyoung

AU - Joung, Boyoung

AU - Lip, Gregory Y.H.

PY - 2019/2/1

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N2 - Objective: To assess the effects of body mass index (BMI) variability on the incidence of new-onset atrial fibrillation (AF), stroke, cardiovascular (CV) risk factors, and CV outcomes in a general Asian population. Patients and Methods: Data from the National Health Insurance Service–Health Screening cohort in Korea were used: 171,324 patients without AF were included, and BMI measurements occurred biennially from January 1, 2002, through December 31, 2009. Patient outcomes were followed through 2013. The BMI intraindividual variability between visits was measured. Results: During mean ± SD follow-up of 47.4±3.9 months, 1959 patients (1.1%) developed new-onset AF. Overweight or obesity (BMI ≥25) had a greater risk of new-onset AF compared with BMI of 20 to 22.5, with a hazard ratio (HR) of 1.24 (95% CI, 1.10-1.41; P<.001). In underweight or normal-weight participants (initial BMI <25), a 1-kg/m2 increase of BMI variability increased the risk of new-onset AF, with an adjusted HR (aHR) of 1.13 (95% CI, 1.01-1.25; P=.02). Weight gain increased the risk of new-onset AF (aHR, 1.32; 95% CI, 1.01-1.71; P=.04) and myocardial infarction (aHR, 1.52; 95% CI, 1.06-2.18; P=.02) but not stroke. In this group, blood pressure, glucose level, and total cholesterol level were higher in individuals with the greatest BMI variability compared with those with stable BMI. Conclusion: In the underweight and normal-weight Asian population, BMI variability, especially weight gain, was related to increased risk of new-onset AF and myocardial infarction. Avoiding weight gain is important to improve CV outcomes.

AB - Objective: To assess the effects of body mass index (BMI) variability on the incidence of new-onset atrial fibrillation (AF), stroke, cardiovascular (CV) risk factors, and CV outcomes in a general Asian population. Patients and Methods: Data from the National Health Insurance Service–Health Screening cohort in Korea were used: 171,324 patients without AF were included, and BMI measurements occurred biennially from January 1, 2002, through December 31, 2009. Patient outcomes were followed through 2013. The BMI intraindividual variability between visits was measured. Results: During mean ± SD follow-up of 47.4±3.9 months, 1959 patients (1.1%) developed new-onset AF. Overweight or obesity (BMI ≥25) had a greater risk of new-onset AF compared with BMI of 20 to 22.5, with a hazard ratio (HR) of 1.24 (95% CI, 1.10-1.41; P<.001). In underweight or normal-weight participants (initial BMI <25), a 1-kg/m2 increase of BMI variability increased the risk of new-onset AF, with an adjusted HR (aHR) of 1.13 (95% CI, 1.01-1.25; P=.02). Weight gain increased the risk of new-onset AF (aHR, 1.32; 95% CI, 1.01-1.71; P=.04) and myocardial infarction (aHR, 1.52; 95% CI, 1.06-2.18; P=.02) but not stroke. In this group, blood pressure, glucose level, and total cholesterol level were higher in individuals with the greatest BMI variability compared with those with stable BMI. Conclusion: In the underweight and normal-weight Asian population, BMI variability, especially weight gain, was related to increased risk of new-onset AF and myocardial infarction. Avoiding weight gain is important to improve CV outcomes.

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