Atrial Fibrillation Risk from Metabolic Transitions in Weight Statuses

Atrial fibrillation is associated with obesity and its related consequences; however, according to Maoxiang Zhao and colleagues, there is a lack of data on whether the change of metabolic and obesity phenotypes affects the risk for atrial fibrillation. In their study, published in Frontiers in Cardiovascular Medicine, they determined that metabolically healthy but overweight or obese patients have increased risk of atrial fibrillation.

Additionally, the research team inferred from their data that “metabolic phenotype was a dynamic condition, and maintenance of metabolic health and normal weight might alleviate the risk of atrial fibrillation.”

The researchers’ analysis initially included 58,483 patients with cardiovascular diseases from the Kailuan study. Metabolic phenotype transitions among the patients were assessed between the first survey (2006-2007) and second survey (2008-2009).

Metabolic Dynamics and Atrial Fibrillation Risk According to BMI

Over a median follow-up period of three years, the investigators identified 580 patients with atrial fibrillation. According to the article, patients with healthy metabolism and patients with unhealthy weight/obesity had adjusted hazard ratios (HRs) of 1.27 (95% CI, 1.01-1.59) and 1.37 (95% CI, 1.09-1.72), respectively, compared to metabolically healthy individuals with normal weight.

Regarding dynamic metabolic transitions, overweight/obese participants who maintained healthy metabolic status were not correlated with increased long-term risk for atrial fibrillation (HR 1.59; 95% ICC, 1.11-2.26). However, as body mass index and metabolic health status were updated during the study, “significant short-term elevations in AF risk were associated with individuals with stable MU-OW/OB [metabolically unhealthy–overweight/obese] status.”

Ultimately, Zhao and the study’s contributors presented two conclusions: “Obesity remains a risk factor for atrial fibrillation independent of major metabolic factors,” and also “metabolic phenotype was a dynamic condition, and maintenance of metabolic health and normal weight might alleviate the risk of atrial fibrillation.”

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