不同BMI水平对新发房颤风险影响的Meta分析

The effect of BMI category on the risk of new-onset atrial fibrillation: a Meta-analysis

目的系统评价不同体质指数(BMI)水平对普通人群新发心房颤动(房颤)风险的影响。方法计算机检索Pubmed、CNKI数据库中关于BMI与普通人群新发房颤风险关系的观察性研究,检索时间截止至2016年7月。根据预先设定的文献纳入与排除标准,由2名评价员独立进行文献筛选、资料提取、质量评价等工作,将符合标准的文献纳入,利用Rev Man 5.3软件进行Meta分析。结果在初步检索得到的685篇文献中,共纳入12篇符合标准的文献。Meta分析结果显示,与正常组相比,超重组的房颤发病风险增加43%(RR=1.43,95%CI:1.30~1.57,P<0.00001),肥胖组的房颤发病风险增加89%(RR=1.89,95%CI:1.69~2.12,P<0.00001);与超重组相比,肥胖组的房颤发病风险增加32%(RR=1.32,95%CI:1.25~1.39,P<0.00001);与非肥胖组相比,肥胖组的房颤发病风险增加55%(RR=1.55,95%CI:1.41~1.69,P<0.00001)。结论超重与肥胖明显增加普通人群新发房颤的风险,随着BMI水平的增加,新发房颤风险也在逐级增加。

Objective To evaluate the effect of different BMI levels on the risk of new atrial fibrillation in the general population. Methods Observational studies of the relationship between BMI and the risk of new atrial fibrillation in the general population published in Pubmed and CNKI database before July 2016 were retrieved.Two reviewers independently completed the literature screening, data extraction and quality evaluation, and used RevMan 5.3 software for meta-analysis. Results There were 12 articles selected from 685 retrieved articles.Compared with the normal group, the risk of atrial fibrillation increased by 43% (RR=1.43, 95%CI: 1.30~1.57,P<0.00001) in the overweight group, and the risk of AF increased by 89% (RR=1.89, 95%CI: 1.69~2.12,P<0.00001) in the obese group. Compared with the overweight group, the risk of atrial fibrillation in the obese group increased by 32% (RR=1.32, 95%CI: 1.25-1.33, P<0.00001). Compared with the non-obese group, the risk of atrial fibrillation in the obese group increased by 55% (RR=1.55, 95%CI: 1.41~1.69, P<0.00001). Conclusion Overweight and obesity significantly increase the risk of new-onset atrial fibrillation in general population, and there is a graded relationship between increased BMI and increased risk of new-onset AF.