Relationship between high BMI, AF risk strongest in Chinese American adults
The relationship between elevated BMI and risk for atrial fibrillation varied by race/ethnicity and was most pronounced in Chinese American adults, researchers reported.
“Prior literature has demonstrated that AF is more prevalent in white patients than Black, Chinese-American and Hispanic patients, but the reason for this is not known. The between-race differences in AF prevalence and incidence are not explained by differences in risk factors,” Matthew J. Singleton, MD, MBE, MHS, MSc, chief electrophysiology fellow at Wake Forest University School of Medicine in Winston-Salem, North Carolina, told Healio.
To characterize the relationship between BMI and AF as well as explore the effect of race, researchers analyzed 6,739 participants (mean age, 62 years; 53% women) from the Multi-Ethnic Study of Atherosclerosis (MESA) for incidences of AF.
“The MESA study is uniquely capable of answering the question of the relationship between BMI and AF risk in different race/ethnic groups, so we sought to assess how they relate and how the relationship may differ by race/ethnicity,” Singleton said in an interview.
During a median of 13.8 years of follow-up, 14.4% of participants had an incident of AF (incidence rate, 12.1 per 1,000 person-years); race-specific incidence rates were 14.5 per 1,000 person-years in white participants, 12.5 per 1,000 person-years in Chinese American participants and 10.1 per 1,000 person-years in both Black and Hispanic participants. Further analysis showed participants with higher-grade obesity were at increased risk for AF (grade II: HR = 1.5; 95% CI, 1.14-1.98; P = .004; grade III: HR = 2.13; 95% CI, 1.48-3.05; P < .0001). The risk for AF as a function of BMI by race varied substantially (P for interaction = .02), with Chinese American participants having a more pronounced risk compared with other races and ethnicities. BMI made little impact on AF risk in Black participants, whereas it was tied to AF risk in white and Hispanic participants but not as strongly as for Chinese American participants, the researchers wrote.
“It is not known why there are differences in the BMI-AF risk relationship between race/ethnic groups, but it is hypothesized that differences in body fat distribution patterns may explain a different relationship between BMI and AF risk,” Singleton told Healio. “Our study lends support to the idea of a race/ethnicity-specific BMI goal and cutoff for elevated risk. Future research should replicate our analysis in other study populations and also explore how changes in BMI influence changes in AF risk and how this relationship may vary by race/ethnicity.”
For more information:
Matthew J. Singleton, MD, MBE, MHS, MSc, can be reached at mjsingle@wakehealth.edu.
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