肥満と新発性心房細動のリスク
Thomas J Wang1, Helen Parise, Daniel Levy
1Framingham Heart Study, Framingham, Mass 01702-5827, USA.
JAMA
|November 25, 2004
まとめ
肥満は,心房細動 (AF) を発症するリスクを高めます. この高いリスクは,左心房の拡大によって引き起こされるようで,体重管理がAFの発生率を減らす可能性があることを示唆しています.
科学分野:
- 心臓病学 心臓病学
- エピデミオロジー エピデミオロジー
- 公衆衛生は公衆衛生である.
背景:
- 肥満は,心房の膨張と,心房細動 (AF) の予測因子として知られている静脈動脈機能不全と関連しています.
- 肥満とAFリスクとの直接的な関連は不明である.
研究 の 目的:
- ボディマス指数 (BMI) とインシデントAFのリスクとの関係を調査する.
- 左心房直径が肥満とAFとの関連を媒介するかどうかを判断する.
主な方法:
- 予見的な,コミュニティベースのコホート研究で,ベースラインAFのない5282人の参加者が参加しました.
- ボディマス指数 (BMI) は,連続変数およびカテゴリ変数 (正常,過体重,肥満) として分析されます.
- 多変量モデルは,臨床的混同因子とエコーカルディオグラフィの左心房直径に調整されています.
主要な成果:
- 13.7年の平均追跡期間で,526人の参加者がAFを発症しました.
- 男性と女性の両方で,より高いBMIカテゴリーでAFの発生率が増加しました.
- 肥満 (BMI ≥30.0) は,AFリスクの増加 (HR 1.52 男性,1.46 女性) と関連していました.
- 左心房直径を調整すると,BMIとAFリスクの関連性はもはや有意ではなかった.
結論:
- 肥満は,AFの重要な,潜在的に修正可能なリスク要因です.
- 左心房の膨張は,肥満に関連したAFリスクの増加を媒介するようです.
- 体重管理の介入は,人口のAF負担を軽減するのに役立ちます.
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