肥胖是心房纤颤(AF)的主要危险因素。观察研究表明，与体重稳定相比，体重增加与新发性AF的风险增加有关。然而，关于减肥和AF风险的结果存在冲突。本研究旨在评估5年体重变化与新发性AF风险之间的关联。该研究基于丹麦饮食、癌症和健康队列的参与者。基线检查时和五年后进行第二次检查时评估了身体质量指数(BMI)。AF和合并症的诊断信息从丹麦国家患者登记处获取。总共纳入了43758名无先前AF病史的参与者。中位年龄为61岁，女性占54%。在中位随访15.7年的过程中，共有5312人出现新发性AF（发病率为8.6/1000人年）。与体重稳定相比，BMI增加2.5到5个单位（kg/m2）与AF风险增加相关（HR 1.24，95% CI 1.09-1.41）。BMI增加5个或更多单位（kg/m2）与新发性AF的风险之比为1.95（95% CI 1.48-2.56）。然而，体重减轻与AF风险之间没有统计学显著关联。与稳定体重相比，丹麦饮食、癌症和健康队列中的5年体重增加与AF风险更高有关。体重减轻与AF风险之间没有统计学显著关联。© 作者2023年。由牛津大学出版社代表欧洲心脏病学会发表。

Obesity is a major risk factor for atrial fibrillation (AF). Compared to stable weight, gaining weight was associated with a higher risk of incident AF in observational studies. The results, however, are conflicting regarding weight loss and risk of AF. This study aimed to assess the association between five-year weight changes and risk of incident AF.The study was based on participants from the Danish Diet, Cancer and Health cohort. Body mass index (BMI) was assessed at a baseline examination and at a second examination five years later. Diagnoses of AF and comorbidities were retrieved from the Danish National Patient Registry.In total, 43,758 participants without prior AF were included. The median age was 61 years and 54% were female. During a median follow-up of 15.7 years, 5,312 individuals had incident AF (incidence rate 8.6/1,000 person-years). Compared to stable weight, weight gain between 2.5 to 5 BMI units (kg/m2) was associated with a higher risk of AF (HR 1.24, 95% CI 1.09-1.41). Weight gain of 5 or more BMI units (kg/m2) was associated with a HR of 1.95 (95% CI 1.48-2.56) of incident AF. However, there was no statistically significant association between weight loss and risk of AF.Five-year weight gain was associated with greater risk of AF compared with stable weight in the Danish Diet, Cancer and Health cohort. There was no statistically significant association between weight loss and risk of AF.© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.