Relative fat mass and prediction of incident atrial fibrillation, heart failure and coronary artery disease in the general population
Authors' conclusion
RFM is associated with incident AF, HF, and CAD and may be used as a simple and intuitive marker of obesity and cardiovascular risk in the general population. This study provides potential RFM cutoffs for CVD prediction that may be used by future studies or preventive strategies targeting obesity and cardiovascular risk.
Study context
- Population
- Adults without prevalent atrial fibrillation (AF), heart failure (HF) or coronary artery disease (CAD) from the population-based Lifelines study; age 45 ± 13 years, 59% women
- Participants
- 95,003 adults
- Exposure
- Relative fat mass (RFM) and RFM cutoffs vs BMI and waist circumference (WC) for cardiovascular disease (CVD) prediction
- Outcome
- Composite of:
- Incident AF
- HF
- CAD (and individual outcomes)
- Follow-up
- Median 3.8 (3.0-4.6) years
Methodological detailsmultivariable logistic regression adjusted for SCORE risk model components
- Multivariable logistic regression adjusted for SCORE risk model components
Main finding
As reported in the abstract
Composite outcome (incident AF, HF and/or CAD), per SD of RFM
Standardised OR, multivariable-adjusted, 95% CI 1.18-1.34
1.26
Observational data: associations, not effects.
Further findings
Incident events · median follow-up 3.8 (3.0-4.6) years
- AF
- 224 (0.2%)
- HF
- 1003 (1.1%)
- CAD
- 657 (0.7%)
Optimal RFM cutoffs (Youden index)
- Men
- ≥26
- Women
- ≥38
- Lower than previously proposed cutoffs (men ≥30, women ≥40)
Discriminative ability vs BMI and WC
- RFM and its cutoffs at least similar (in women) or better (in men) compared to BMI and WC
Age-specific RFM cutoffs
- Men
- 23 to 27
- Women
- 33 to 43
Original publication
Relative fat mass and prediction of incident atrial fibrillation, heart failure and coronary artery disease in the general population. Int J Obes (Lond). Published 9 September 2023. doi:10.
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