Sex-specific associations of body mass index and waist circumference loss with the risk of atrial fibrillation.

AIMS: To investigate sex-stratified associations between 4-year weight loss and risk of incident atrial fibrillation (AF) in a prospective cohort study and the potential benefits of sustained weight management.

MATERIALS AND

METHODS

We analysed 60 402 participants from the Kailuan Study free of AF, with body mass index (BMI) and waist circumference (WC) measured in 2006-2007 and 2010-2011. Reductions in BMI, body weight, and WC were used to define weight loss. Cox proportional hazards models assessed the association between weight loss and incident AF, adjusting for relevant covariates.

RESULTS

During a median follow-up of 13.0 years (interquartile range: 12.5-13.3), 582 participants developed AF (484 men, 98 women). In men, BMI reduction >2.5 kg/m2 (hazard ratio [HR] 0.663, 95% confidence interval [CI] 0.467-0.940), body weight loss >5 kg (HR 0.662, 95% CI 0.468-0.936), and WC reduction >4 cm (HR 0.768, 95% CI 0.601-0.982) were associated with a lower risk of incident AF. In women, WC reduction >4 cm (HR 0.499, 95% CI 0.279-0.892) was associated with a lower risk. Similar patterns were observed among participants with overweight or obesity. Formal tests for sex interaction were not statistically significant.

CONCLUSIONS

Reductions in BMI, body weight, and WC were associated with lower risk of incident AF, particularly in overweight or obese participants. The magnitude of association differed by anthropometric measure and sex, with BMI change showing stronger associations in men and WC change in women. Anthropometric changes may aid risk stratification and inform prevention efforts in higher-risk groups.