RISKS OF ATRIAL FIBRILLATION IN ATHLETES WITH ELEVATED BMI: A SYSTEMATIC REVIEW AND META-ANALYSIS IN SPORTS HEALTH CONTEXTS

Abstract

Objective: To systematically investigate the relationship between being overweight and the risk of atrial fibrillation (AF) among individuals attending physical examination centers, with a focus on implications for athletes and physically active populations. Methods: Comprehensive searches were conducted across multiple databases including PubMed, EMBASE, Science Direct, and several Chinese databases from January 2010 to the present. This meta-analysis included observational studies comparing the incidence of AF in overweight individuals versus those with a normal weight range within physical examination settings. Data extraction was performed independently by two researchers, and bias risk was assessed using Cochrane standards with analyses conducted via RevMan5.3. Results: Seven studies were included, encompassing a total of 340,353 participants. The incidence of AF in overweight individuals was 2.12%, compared to 0.61% in those of normal weight. Meta-analysis using a fixed-effect model showed the obese subgroup had a higher incidence of AF at 3.23%. The risk of AF was significantly increased in the obese group compared to the overweight group (RR=1.33, 95%CI: 1.24-1.42, P<0.00001) and normal-weight group (RR=1.93, 95%CI: 1.67-2.24, P<0.00001). Publication bias was suggested by asymmetrical funnel plots, indicating potential underreporting in the included studies. Conclusion: Overweight and obesity are significantly correlated with an increased risk of developing new-onset atrial fibrillation, especially among individuals who are physically active. This risk escalates further with increasing BMI. The findings underscore the importance of weight management in the prevention of AF, particularly in populations engaged in regular physical activities or sports. Further high-quality, longitudinal studies are needed to substantiate these findings.