Abstract
BackgroundBodyweight variability is a risk factor for atrial fibrillation (AF). We aimed to examine the relationship between bodyweight variability and the risk of AF in patients with type 2 diabetes mellitus (DM), and whether this relationship was affected by baseline body mass index (BMI), weight change, or advanced diabetic stage.MethodsA nationwide population-based cohort of 670,797 patients with type 2 DM from the Korean National Health Insurance Service database without a history of AF and with ≥ 3 measurements of bodyweight over a 5-year period were followed up for AF development. Intra-individual bodyweight variability was calculated using variability independent of mean, and high bodyweight variability was defined as the quintile with the highest variability with the lower four quintiles as reference.ResultsDuring a median of 7.0 years of follow-up, 22,019 patients (3.3%) newly developed AF. After multivariate adjustment, those in the highest quintile of bodyweight variability showed a higher risk of incident AF (HR 1.16, 95% CI 1.12–1.20) compared to those in the lower 4 quintiles with reference bodyweight variability, irrespective of baseline BMI group and direction of overall weight change. This association was greater in magnitude in subjects with lower BMI, those on insulin, and those with a DM duration of greater than 5 years. In sensitivity analyses, high bodyweight variability was consistently associated with AF development using other indices of variability and adjusting for glycemic variability.ConclusionsHigh variability in bodyweight was associated with AF development, independently of traditional cardiovascular risk factors and baseline BMI. This association was stronger in underweight patients and with advanced diabetic stage. Weight fluctuation may interfere with the beneficial effects of weight loss and should be avoided when possible in weight control regimens for DM patients.
Highlights
Bodyweight variability is a risk factor for atrial fibrillation (AF)
The purpose of this study was to examine the relationship between bodyweight variability and the risk of AF in patients with type 2 diabetes mellitus (DM), and whether this relationship was affected by baseline body mass index, weight change, or advanced diabetic stage
Around two-thirds of the subjects were on oral anti-diabetic medication, and 8% were on insulin
Summary
Bodyweight variability is a risk factor for atrial fibrillation (AF). Atrial fibrillation (AF) is the most common sustained arrhythmia in the general population, and its prevalence is progressively increasing [1]. Lee et al Cardiovasc Diabetol (2020) 19:78 weight loss lower the risk of AF development or AF burden [6,7,8], and weight loss is recommended in overweight and obese DM patients [9]. Bodyweight fluctuation has been associated with increased cardiovascular events and mortality in the general population and patients with coronary artery disease [11, 12] as well as in DM patients [13, 14]. Bodyweight variability has been associated with an increased risk of AF in the general population [15], but this has not been studied with a specific focus on the diabetic population
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
