Lean body mass and risk of incident atrial fibrillation in post-menopausal women

Farnaz Azarbal, Marcia L. Stefanick, Themistocles L. Assimes, Joann E. Manson, Jennifer W. Bea, Wenjun Li, Mark A. Hlatky, Joseph C. Larson, Erin S. Leblanc, Christine M. Albert, Rami Nassir, Lisa W. Martin, Marco V. Perez

Research output: Contribution to journalArticlepeer-review

33 Scopus citations


Aims High body mass index (BMI) is a risk factor for atrial fibrillation (AF). The aim of this study was to determine whether lean body mass (LBM) predicts AF. Methods and results The Women's Health Initiative is a study of post-menopausal women aged 50-79 enrolled at 40 US centres from 1994 to 1998. A subset of 11 393 participants at three centres underwent dual-energy X-ray absorptiometry. Baseline demographics and clinical histories were recorded. Incident AF was identified using hospitalization records and diagnostic codes from Medicare claims. A multivariable Cox hazard regression model adjusted for demographic and clinical risk factors was used to evaluate associations between components of body composition and AF risk. After exclusion for prevalent AF or incomplete data, 8832 participants with an average age of 63.3 years remained for analysis. Over the 11.6 years of average follow-up time, 1035 women developed incident AF. After covariate adjustment, all measures of LBM were independently associated with higher rates of AF: total LBM [hazard ratio (HR) 1.24 per 5 kg increase, 95% confidence intervals (CI) 1.14-1.34], central LBM (HR 1.51 per 5 kg increase, 95% CI 1.31-1.74), and peripheral LBM (HR 1.39 per 5 kg increase, 95% CI 1.19-1.63). The association between total LBM and AF remained significant after adjustment for total fat mass (HR 1.22 per 5 kg increase, 95% CI 1.13-1.31). Conclusion Greater LBM is a strong independent risk factor for AF. After adjusting for obesity-related risk factors, the risk of AF conferred by higher BMI is primarily driven by the association between LBM and AF. Published on behalf of the European Society of Cardiology. All rights reserved.

Original languageEnglish (US)
Pages (from-to)1606-1613
Number of pages8
JournalEuropean Heart Journal
Issue number20
StatePublished - May 21 2016


  • Arrhythmia
  • Atrial fibrillation
  • Epidemiology

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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