title: Associations of obesity and body fat distribution with incident atrial fibrillation in the biracial health aging and body composition cohort of older adults.
abstract: Obesity is a well-recognized risk factor for atrial fibrillation (AF), yet adiposity measures other than body mass index (BMI) have had limited assessment in relation to AF risk. We examined the associations of adiposity measures with AF in a biracial cohort of older adults. Given established racial differences in obesity and AF, we assessed for differences by black and white race in relating adiposity and AF.
  
  
  METHODS
  We analyzed data from 2,717 participants of the Health, Aging, and Body Composition Study. Adiposity measures were BMI, abdominal circumference, subcutaneous and visceral fat area, and total and percent fat mass. We determined the associations between the adiposity measures and 10-year incidence of AF using Cox proportional hazards models and assessed for their racial differences in these estimates.
  
  
  RESULTS
  In multivariable-adjusted models, 1-SD increases in BMI, abdominal circumference, and total fat mass were associated with a 13% to 16% increased AF risk (hazard ratio [HR] 1.14, 95% CI 1.02-1.28; HR 1.16, 95% CI 1.04-1.28; and HR 1.13, 95% CI 1.002-1.27). Subcutaneous and visceral fat areas were not significantly associated with incident AF. We did not identify racial differences in the associations between the adiposity measures and AF.
  
  
  CONCLUSIONS
  Body mass index, abdominal circumference, and total fat mass are associated with risk of AF for 10years among white and black older adults. Obesity is one of a limited number of modifiable risk factors for AF; future studies are essential to evaluate how obesity reduction can modify the incidence of AF.
authors.affiliation: Department of Medicine, Boston Medical Center, Boston University, Boston, MA.
authors.forename: Konstantinos N
authors.initials: KN
authors.lastname: Aronis
authors.affiliation: Data Coordinating Center, Boston University School of Public Health, Boston, MA.
authors.forename: Na
authors.initials: N
authors.lastname: Wang
authors.affiliation: Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MD.
authors.forename: Caroline L
authors.initials: CL
authors.lastname: Phillips
authors.affiliation: Cardiology Section, Whitaker Cardiovascular Institute, Evans Department of Medicine, Boston University School of Medicine, Boston, MA; National Heart Lung and Blood Institute's and Boston University's Framingham Heart Study, Framingham, MA; Department of Epidemiology, Boston University School of Public Health, Boston, MA.
authors.forename: Emelia J
authors.initials: EJ
authors.lastname: Benjamin
authors.affiliation: Electrophysiology Section, Division of Cardiology, University of California, San Francisco, CA.
authors.forename: Gregory M
authors.initials: GM
authors.lastname: Marcus
authors.affiliation: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Anne B
authors.initials: AB
authors.lastname: Newman
authors.affiliation: Department of General Internal Medicine, Inselspital, Bern University Hospital, Bern, Switzerland.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Rodondi
authors.affiliation: Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Satterfield
authors.affiliation: Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MD.
authors.forename: Tamara B
authors.initials: TB
authors.lastname: Harris
authors.affiliation: Cardiology Section, Whitaker Cardiovascular Institute, Evans Department of Medicine, Boston University School of Medicine, Boston, MA; National Heart Lung and Blood Institute's and Boston University's Framingham Heart Study, Framingham, MA. Electronic address: jmagnani@bu.edu.
authors.forename: Jared W
authors.initials: JW
authors.lastname: Magnani
mesh_terms: D000368:Aged; D000375:Aging; D001281:Atrial Fibrillation / Q000208:ethnology* / Q000209:etiology / Q000503:physiopathology; D001823:Body Composition; D050218:Body Fat Distribution; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D009765:Obesity / Q000150:complications* / Q000208:ethnology; D011446:Prospective Studies; D044469:Racial Groups; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology