Measures of Body Size and Composition and Risk of Incident Atrial Fibrillation in Older People

Maria G. Karas, Laura M. Yee, Mary L. Biggs, Luc Djoussé, Kenneth J. Mukamal, H. Joachim, Susan J. Zieman, David S. Siscovick, John S. Gottdiener, Michael A. Rosenberg, Richard A. Kronmal, Susan R. Heckbert, Jorge Kizer

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Various anthropometric measures, including height, have been associated with atrial fibrillation (AF). This raises questions about the appropriateness of using ratio measures such as body mass index (BMI), which contains height squared in its denominator, in the evaluation of AF risk. Among older adults, the optimal anthropometric approach to risk stratification of AF remains uncertain. Anthropometric and bioelectrical impedance measures were obtained from 4,276 participants (mean age = 72.4 years) free of cardiovascular disease in the Cardiovascular Health Study. During follow-up (1989-2008), 1,050 cases of AF occurred. BMI showed a U-shaped association, whereas height, weight, waist circumference, hip circumference, fat mass, and fat-free mass were linearly related to incident AF. The strongest adjusted association occurred for height (per each 1-standard-deviation increment, hazard ratio = 1.38, 95% confidence interval: 1.25, 1.51), which exceeded all other measures, including weight (hazard ratio = 1.21, 95% confidence interval: 1.13, 1.29). Combined assessment of log-transformed weight and height showed regression coefficients that departed from the 1 to -2 ratio inherent in BMI, indicating a loss of predictive information. Risk estimates for AF tended to be stronger for hip circumference than for waist circumference and for fat-free mass than for fat mass, which was explained largely by height. These findings highlight the prominent role of body size and the inadequacy of BMI as determinants of AF in older adults.

Original languageEnglish (US)
Pages (from-to)998-1007
Number of pages10
JournalAmerican Journal of Epidemiology
Volume183
Issue number11
DOIs
StatePublished - Jun 1 2016

Fingerprint

Body Size
Body Composition
Atrial Fibrillation
Body Mass Index
Fats
Waist Circumference
Weights and Measures
Hip
Confidence Intervals
Electric Impedance
Cardiovascular Diseases
Health

Keywords

  • aging
  • atrial fibrillation
  • body size
  • obesity

ASJC Scopus subject areas

  • Epidemiology

Cite this

Measures of Body Size and Composition and Risk of Incident Atrial Fibrillation in Older People. / Karas, Maria G.; Yee, Laura M.; Biggs, Mary L.; Djoussé, Luc; Mukamal, Kenneth J.; Joachim, H.; Zieman, Susan J.; Siscovick, David S.; Gottdiener, John S.; Rosenberg, Michael A.; Kronmal, Richard A.; Heckbert, Susan R.; Kizer, Jorge.

In: American Journal of Epidemiology, Vol. 183, No. 11, 01.06.2016, p. 998-1007.

Research output: Contribution to journalArticle

Karas, MG, Yee, LM, Biggs, ML, Djoussé, L, Mukamal, KJ, Joachim, H, Zieman, SJ, Siscovick, DS, Gottdiener, JS, Rosenberg, MA, Kronmal, RA, Heckbert, SR & Kizer, J 2016, 'Measures of Body Size and Composition and Risk of Incident Atrial Fibrillation in Older People', American Journal of Epidemiology, vol. 183, no. 11, pp. 998-1007. https://doi.org/10.1093/aje/kwv278
Karas, Maria G. ; Yee, Laura M. ; Biggs, Mary L. ; Djoussé, Luc ; Mukamal, Kenneth J. ; Joachim, H. ; Zieman, Susan J. ; Siscovick, David S. ; Gottdiener, John S. ; Rosenberg, Michael A. ; Kronmal, Richard A. ; Heckbert, Susan R. ; Kizer, Jorge. / Measures of Body Size and Composition and Risk of Incident Atrial Fibrillation in Older People. In: American Journal of Epidemiology. 2016 ; Vol. 183, No. 11. pp. 998-1007.
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