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High variability in bodyweight is associated with an increased risk of atrial fibrillation in patients with type 2 diabetes mellitus: a nationwide cohort study

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dc.contributor.authorLee, Hyun-Jung-
dc.contributor.authorChoi, Eue-Keun-
dc.contributor.authorHan, Kyung-Do-
dc.contributor.authorKim, Da Hye-
dc.contributor.authorLee, Euijae-
dc.contributor.authorLee, So-Ryoung-
dc.contributor.authorOh, Seil-
dc.contributor.authorLip, Gregory Y H-
dc.date.accessioned2020-07-15T05:26:43Z-
dc.date.available2020-07-15T14:27:43Z-
dc.date.issued2020-06-13-
dc.identifier.citationCardiovascular Diabetology. 2020 Jun 13;19(1):78ko_KR
dc.identifier.issn1475-2840-
dc.identifier.urihttps://hdl.handle.net/10371/168592-
dc.description.abstractBackground
Bodyweight variability is a risk factor for atrial fibrillation (AF). We aimed to examine the relationship between bodyweight variability and the risk of AF in patients with type 2 diabetes mellitus (DM), and whether this relationship was affected by baseline body mass index (BMI), weight change, or advanced diabetic stage.

Methods
A nationwide population-based cohort of 670,797 patients with type 2 DM from the Korean National Health Insurance Service database without a history of AF and with ≥ 3 measurements of bodyweight over a 5-year period were followed up for AF development. Intra-individual bodyweight variability was calculated using variability independent of mean, and high bodyweight variability was defined as the quintile with the highest variability with the lower four quintiles as reference.

Results
During a median of 7.0 years of follow-up, 22,019 patients (3.3%) newly developed AF. After multivariate adjustment, those in the highest quintile of bodyweight variability showed a higher risk of incident AF (HR 1.16, 95% CI 1.12–1.20) compared to those in the lower 4 quintiles with reference bodyweight variability, irrespective of baseline BMI group and direction of overall weight change. This association was greater in magnitude in subjects with lower BMI, those on insulin, and those with a DM duration of greater than 5 years. In sensitivity analyses, high bodyweight variability was consistently associated with AF development using other indices of variability and adjusting for glycemic variability.

Conclusions
High variability in bodyweight was associated with AF development, independently of traditional cardiovascular risk factors and baseline BMI. This association was stronger in underweight patients and with advanced diabetic stage. Weight fluctuation may interfere with the beneficial effects of weight loss and should be avoided when possible in weight control regimens for DM patients.
ko_KR
dc.language.isoenko_KR
dc.publisherBMCko_KR
dc.subjectDiabetes mellitus-
dc.subjectBodyweight-
dc.subjectVariability-
dc.subjectAtrial fbrillation-
dc.subjectObesity-
dc.titleHigh variability in bodyweight is associated with an increased risk of atrial fibrillation in patients with type 2 diabetes mellitus: a nationwide cohort studyko_KR
dc.typeArticleko_KR
dc.contributor.AlternativeAuthor이현정-
dc.contributor.AlternativeAuthor최유근-
dc.contributor.AlternativeAuthor한경도-
dc.contributor.AlternativeAuthor김다혜-
dc.contributor.AlternativeAuthor이유재-
dc.contributor.AlternativeAuthor이소령-
dc.contributor.AlternativeAuthor오세일-
dc.identifier.doidoi.org/10.1186/s12933-020-01059-8-
dc.citation.journaltitleCardiovascular Diabetologyko_KR
dc.language.rfc3066en-
dc.rights.holderThe Author(s)-
dc.date.updated2020-06-16T09:34:49Z-
dc.citation.number1ko_KR
dc.citation.startpage78ko_KR
dc.citation.volume19ko_KR
Appears in Collections:
College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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