关于体重变化和心房颤动 (AF) 的流行病学证据仍然有限且不一致。先前关于青少年体重指数（BMI）和房颤的研究很少考虑随后的体重指数。本研究旨在评估 AF 与青少年体重变化和 BMI 的关联，以及 AF 遗传易感性的改变效应。该研究纳入了来自马尔默饮食和癌症队列的 21,761 名个体（平均年龄 57.8 岁）。在三个时间点获取体重信息，包括 20 岁时回忆的体重、基线时测量的体重（成年中期）以及 5 年随访检查时报告的体重（成年中期）。使用 134 个变异创建了 AF 加权遗传风险评分。在中位随访 23.2 年期间，共有 4038 名参与者出现了 AF。从成年早期到中期的体重变化与 AF 风险之间的关联因性别而改变（Pinteraction = 0.004）；女性体重减轻与房颤风险降低相关，但男性则不然。相反，在女性中，体重增加与房颤风险呈线性正相关，而在男性中，只有当体重增加超过阈值时，房颤风险才会增加。与体重稳定的参与者相比，中年至中后期体重增加超过 5 公斤的参与者发生 AF 的风险高出 19%，而体重减轻则显示出零关联。与 20 岁时 BMI 较低的个体相比，在控制基线 BMI 后，BMI 高于 25 kg/m2 的个体发生 AF 的风险增加（HR = 1.14；95% CI：1.02-1.28）；这种关联在男性或房颤遗传风险较低的人群中更为明显。中年体重增加与房颤风险较高相关。仅在女性中，从成年早期到中期的体重减轻与较低的房颤风险相关，但与中年晚期的体重减轻无关。青少年中较高的 BMI 与 AF 风险增加相关，尤其是男性或 AF 遗传风险较低的人群。© 2024。作者。

Epidemiological evidence on weight change and atrial fibrillation (AF) remains limited and inconsistent. Previous studies on body mass index (BMI) in youth and AF rarely considered subsequent BMI. This study aimed to assess the associations of AF with weight change and BMI in youth, as well as modified effect by genetic susceptibility of AF.The study included 21,761 individuals (mean age 57.8 years) from the Malmö Diet and Cancer cohort. Weight information was obtained at three time points, including recalled weight at age 20 years, measured weight at baseline (middle adulthood), and reported weight at 5-year follow-up examination (late middle adulthood). A weighted genetic risk score of AF was created using 134 variants.During a median follow-up of 23.2 years, a total of 4038 participants developed AF. The association between weight change from early to middle adulthood and AF risk was modified by sex (Pinteraction = 0.004); weight loss was associated with a lower AF risk in females, but not in males. Conversely, weight gain was positively associated with AF risk in a linear manner in females, whereas increased AF risk appeared only when weight gain exceeded a threshold in males. Participants with weight gain of > 5 kg from middle to late middle adulthood had a 19% higher risk of AF relative to those with stable weight, whereas weight loss showed a null association. Compared to individuals with a lower BMI at age 20 years, those with a BMI above 25 kg/m2 had an increased risk of AF (HR = 1.14; 95% CI: 1.02-1.28), after controlling for baseline BMI; this association was more pronounced in males or those with a lower genetic risk of AF.Weight gain in middle adulthood was associated with higher AF risk. Weight loss from early to middle adulthood, but not from middle to late middle adulthood, was associated with a lower risk of AF only in females. Higher BMI in youth was associated with an increased risk of AF, particularly among males or those with a lower genetic risk of AF.© 2024. The Author(s).