The impact of body weight and diabetes on new-onset atrial fibrillation: a nationwide population based study
- Authors
- Kim, Yun Gi; Han, Kyung-Do; Choi, Jong-Il; Boo, Ki Yung; Kim, Do Young; Oh, Suk-Kyu; Lee, Kwang-No; Shim, Jaemin; Kim, Jin Seok; Kim, Young-Hoon
- Issue Date
- 1-10월-2019
- Publisher
- BMC
- Keywords
- Atrial fibrillation; Body weight; Waist circumference; Diabetes
- Citation
- CARDIOVASCULAR DIABETOLOGY, v.18, no.1
- Indexed
- SCIE
SCOPUS
- Journal Title
- CARDIOVASCULAR DIABETOLOGY
- Volume
- 18
- Number
- 1
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/62579
- DOI
- 10.1186/s12933-019-0932-z
- ISSN
- 1475-2840
- Abstract
- Background Being obese or underweight, and having diabetes are important risk factors for new-onset atrial fibrillation (AF). However, it is unclear whether there is any interaction between body weight and diabetes in regard to development of new-onset AF. We aimed to evaluate the role of body weight status and various stage of diabetes on new-onset AF. Methods This was a nationwide population based study using National Health Insurance Service (NHIS) data. A total of 9,797,418 patients who underwent national health check-ups were analyzed. Patients were classified as underweight [body mass index (BMI) < 18.5], normal reference group (18.5 <= BMI < 23.0), upper normal (23.0 <= BMI < 25.0), overweight (25.0 <= BMI < 30.0), or obese (BMI >= 30.0) based on BMI. Diabetes were categorized as non-diabetic, impaired fasting glucose (IFG), new-onset diabetes, diabetes < 5 years, and diabetes >= 5 years. Primary outcome end point was new-onset AF. New-onset AF was defined as one inpatient or two outpatient records of International Classification of Disease, Tenth Revision (ICD-10) codes in patients without prior AF diagnosis. Results During 80,130,161 patient*years follow-up, a total of 196,136 new-onset AF occurred. Obese [hazard ration (HR) = 1.327], overweight (HR = 1.123), upper normal (HR = 1.040), and underweight (HR = 1.055) patients showed significantly increased risk of new-onset AF compared to the normal reference group. Gradual escalation in the risk of new-onset AF was observed along with advancing diabetic stage. Body weight status and diabetes were independently associated with new-onset AF and at the same time, had synergistic effects on the risk of new-onset AF with obese diabetic patients having the highest risk (HR = 1.823). Conclusions Patients with obesity, overweight, underweight, and diabetes had significantly increased risk of new-onset AF. Body weight status and diabetes had synergistic effects on the risk of new-onset AF. The risk of new-onset AF increased gradually with advancing diabetic stage. This study suggests that maintaining optimal body weight and glucose homeostasis might prevent new-onset AF.
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Collections - College of Medicine > Department of Medical Science > 1. Journal Articles
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