Different adiposity measures have been associ-
ated with increased risk of atrial fibrillation, however,
results have previously only been summarized for BMI.
We therefore conducted a systematic review and meta-
analysis of prospective studies to clarify the association
between different adiposity measures and risk of atrial
fibrillation. PubMed and Embase databases were searched
up to October 24th 2016. Summary relative risks (RRs)
were calculated using random effects models. Twenty-nine
unique prospective studies (32 publications) were included.
Twenty-five studies (83,006 cases, 2,405,381 participants)
were included in the analysis of BMI and atrial fibrillation.
The summary RR was 1.28 (95% confidence interval:
1.20–1.38, I
2
=
97%) per 5 unit increment in BMI, 1.18
(95% CI: 1.12–1.25, I
2
=
73%, n
=
5) and 1.32 (95% CI:
1.16–1.51, I
2
=
91%, n
=
3) per 10 cm increase in waist
and hip circumference, respectively, 1.09 (95% CI:
1.02–1.16, I
2
=
44%, n
=
4) per 0.1 unit increase in waist-
to-hip ratio, 1.09 (95% CI: 1.02–1.16, I
2
=
94%, n
=
4)
per 5 kg increase in fat mass, 1.10 (95% CI: 0.92–1.33,
I
2
=
90%, n
=
3) per 10% increase in fat percentage,
1.10 (95% CI: 1.08–1.13, I
2
=
74%, n
=
10) per 5 kg
increase in weight, and 1.08 (95% CI: 0.97–1.19,
I
2
=
86%, n
=
2) per 5% increase in weight gain. The
association between BMI and atrial fibrillation was non-
linear,
p
nonlinearity
\
0.0001, with a stronger association at
higher BMI levels, however, increased risk was observed
even at a BMI of 22–24 compared to 20. In conclusion,
general and abdominal adiposity and higher body fat mass
increase the risk of atrial fibrillation.