Underweight is a major risk factor for atrial fibrillation in Asian people with type 2 diabetes mellitus

Abstract Background Atrial fibrillation (AF) is prevalent in patients with type 2 diabetes mellitus (T2DM). Obesity commonly accompanies T2DM, and increases the risk of AF. However, the dose-relationship between body mass index (BMI) and AF risk has seldom been studied in patients with diabetes. Met...

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Autores principales:	Jung-Chi Hsu, Yen-Yun Yang, Shu-Lin Chuang, Yi-Wei Chung, Chih-Hsien Wang, Lian-Yu Lin
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Body mass index Atrial fibrillation Obesity paradox Diabetes mellitus Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/75750815598244fa866990311ad32d5b
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spelling	oai:doaj.org-article:75750815598244fa866990311ad32d5b2021-11-28T12:14:07ZUnderweight is a major risk factor for atrial fibrillation in Asian people with type 2 diabetes mellitus10.1186/s12933-021-01415-21475-2840https://doaj.org/article/75750815598244fa866990311ad32d5b2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12933-021-01415-2https://doaj.org/toc/1475-2840Abstract Background Atrial fibrillation (AF) is prevalent in patients with type 2 diabetes mellitus (T2DM). Obesity commonly accompanies T2DM, and increases the risk of AF. However, the dose-relationship between body mass index (BMI) and AF risk has seldom been studied in patients with diabetes. Methods This cohort study utilized a database from National Taiwan University Hospital, a tertiary medical center in Taiwan. Between 2014 and 2019, 64,339 adult patients with T2DM were enrolled for analysis. BMI was measured and categorized as underweight (BMI < 18.5), normal (18.5 ≤ BMI < 24), overweight (24 ≤ BMI < 27), obesity class 1 (27 ≤ BMI < 30), obesity class 2 (30 ≤ BMI < 35), or obesity class 3 (BMI ≥ 35). Multivariate Cox regression and spline regression models were employed to estimate the relationship between BMI and the risk of AF in patients with T2DM. Results The incidence of AF was 1.97 per 1000 person-years (median follow-up, 70.7 months). In multivariate Cox regression, using normal BMI as the reference group, underweight (HR 1.52, 95% CI 1.25–1.87, p < 0.001) was associated with a significantly higher risk of AF, while overweight was associated with significantly reduced risk of AF (HR 0.82, 95% CI 0.73–0.89, p < 0.001). Kaplan–Meier analysis showed AF risk was highest in the underweight group, followed by obesity class 3, while the overweight group had the lowest incidence of AF (log-rank test, p < 0.001). The cubic restrictive spline model revealed a “J-shaped” or “L-shaped” relationship between BMI and AF risk. Conclusions Underweight status confers the highest AF risk in Asian patients with T2DM.Jung-Chi HsuYen-Yun YangShu-Lin ChuangYi-Wei ChungChih-Hsien WangLian-Yu LinBMCarticleBody mass indexAtrial fibrillationObesity paradoxDiabetes mellitusDiseases of the circulatory (Cardiovascular) systemRC666-701ENCardiovascular Diabetology, Vol 20, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Body mass index Atrial fibrillation Obesity paradox Diabetes mellitus Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Body mass index Atrial fibrillation Obesity paradox Diabetes mellitus Diseases of the circulatory (Cardiovascular) system RC666-701 Jung-Chi Hsu Yen-Yun Yang Shu-Lin Chuang Yi-Wei Chung Chih-Hsien Wang Lian-Yu Lin Underweight is a major risk factor for atrial fibrillation in Asian people with type 2 diabetes mellitus
description	Abstract Background Atrial fibrillation (AF) is prevalent in patients with type 2 diabetes mellitus (T2DM). Obesity commonly accompanies T2DM, and increases the risk of AF. However, the dose-relationship between body mass index (BMI) and AF risk has seldom been studied in patients with diabetes. Methods This cohort study utilized a database from National Taiwan University Hospital, a tertiary medical center in Taiwan. Between 2014 and 2019, 64,339 adult patients with T2DM were enrolled for analysis. BMI was measured and categorized as underweight (BMI < 18.5), normal (18.5 ≤ BMI < 24), overweight (24 ≤ BMI < 27), obesity class 1 (27 ≤ BMI < 30), obesity class 2 (30 ≤ BMI < 35), or obesity class 3 (BMI ≥ 35). Multivariate Cox regression and spline regression models were employed to estimate the relationship between BMI and the risk of AF in patients with T2DM. Results The incidence of AF was 1.97 per 1000 person-years (median follow-up, 70.7 months). In multivariate Cox regression, using normal BMI as the reference group, underweight (HR 1.52, 95% CI 1.25–1.87, p < 0.001) was associated with a significantly higher risk of AF, while overweight was associated with significantly reduced risk of AF (HR 0.82, 95% CI 0.73–0.89, p < 0.001). Kaplan–Meier analysis showed AF risk was highest in the underweight group, followed by obesity class 3, while the overweight group had the lowest incidence of AF (log-rank test, p < 0.001). The cubic restrictive spline model revealed a “J-shaped” or “L-shaped” relationship between BMI and AF risk. Conclusions Underweight status confers the highest AF risk in Asian patients with T2DM.
format	article
author	Jung-Chi Hsu Yen-Yun Yang Shu-Lin Chuang Yi-Wei Chung Chih-Hsien Wang Lian-Yu Lin
author_facet	Jung-Chi Hsu Yen-Yun Yang Shu-Lin Chuang Yi-Wei Chung Chih-Hsien Wang Lian-Yu Lin
author_sort	Jung-Chi Hsu
title	Underweight is a major risk factor for atrial fibrillation in Asian people with type 2 diabetes mellitus
title_short	Underweight is a major risk factor for atrial fibrillation in Asian people with type 2 diabetes mellitus
title_full	Underweight is a major risk factor for atrial fibrillation in Asian people with type 2 diabetes mellitus
title_fullStr	Underweight is a major risk factor for atrial fibrillation in Asian people with type 2 diabetes mellitus
title_full_unstemmed	Underweight is a major risk factor for atrial fibrillation in Asian people with type 2 diabetes mellitus
title_sort	underweight is a major risk factor for atrial fibrillation in asian people with type 2 diabetes mellitus
publisher	BMC
publishDate	2021
url	https://doaj.org/article/75750815598244fa866990311ad32d5b
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_version_	1718408147517833216

Underweight is a major risk factor for atrial fibrillation in Asian people with type 2 diabetes mellitus

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