Background Atrial fibrillation (AF) has a higher prevalence in men than in women and is associated with measures of adiposity and lean mass (LM). However, it remains uncertain whether the risks of AF associated with these measures vary by sex. Methods Among 477 904 UK Biobank participants aged 40–69 without prior AF, 23 134 incident AF cases were identified (14 400 men, 8734 women; median follow-up 11.1 years). Cox proportional hazards models were used to estimate the covariate adjusted hazard ratios (HRs) describing the association of AF with weight, measures of adiposity [fat mass (FM), waist circumference (WC)] and LM, and their independent relevance, by sex. Results Weight and WC were independently associated with risk of AF [HR: 1.25 (1.23–1.27) per 10 kg, HR: 1.11 (1.09–1.14) per 10 cm, respectively], with comparable effects in both sexes. The association with weight was principally driven by LM, which, per 5 kg, conferred double the risk of AF compared with FM when mutually adjusted [HR: 1.20 (1.19–1.21), HR: 1.10 (1.09–1.11), respectively]; however, the effect of LM was weaker in men than in women (p-interaction = 4.3 x 10−9). Comparing the relative effects of LM, FM and WC identified different patterns within each sex; LM was the strongest predictor for both, whereas WC was stronger than FM in men but not in women. Conclusions LM and FM (as constituents of weight) and WC are risk factors for AF. However, the independent relevance of general adiposity for AF was more limited in men than in women. The relevance of both WC and LM suggests a potentially important role for visceral adiposity and muscle mass in AF development.

中文翻译：

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肥胖措施对男性和女性房颤风险的独立影响：一项针对 50 万人的研究


背景 心房颤动（AF）在男性中的患病率高于女性，并且与肥胖和瘦体重（LM）的测量相关。然而，仍不确定与这些措施相关的房颤风险是否因性别而异。方法 在 477 904 名年龄在 40-69 岁且无房颤史的英国生物银行参与者中，发现了 23 134 例房颤病例（男性 14 400 名，女性 8 734 名；中位随访时间 11.1 年）。 Cox 比例风险模型用于估计描述 AF 与体重、肥胖指标 [脂肪量 (FM)、腰围 (WC)] 和 LM 之间关系的协变量调整风险比 (HR)，以及它们按性别的独立相关性。结果 体重和腰围与 AF 风险独立相关 [HR：每 10 kg 1.25 (1.23–1.27)，HR：每 10 cm 1.11 (1.09–1.14)]，两性的影响相当。与体重的关联主要是由 LM 驱动的，在相互调整时，每 5 kg 的 AF 风险是 FM 的两倍 [HR：分别为 1.20 (1.19–1.21)，HR：1.10 (1.09–1.11)]；然而，LM 对男性的影响弱于女性（p 交互作用 = 4.3 x 10−9）。比较 LM、FM 和 WC 的相对影响，发现了每个性别的不同模式； LM 对两者都是最强的预测因子，而 WC 在男性中比 FM 更强，但在女性中则不然。结论 LM 和 FM（作为体重的组成部分）和 WC 是 AF 的危险因素。然而，一般肥胖与房颤的独立相关性在男性中比在女性中更有限。 WC 和 LM 的相关性表明内脏肥胖和肌肉质量在 AF 发展中具有潜在的重要作用。