Osteosarcopenia and risk of atrial fibrillation from the UK Biobank

Abstract Background Osteosarcopenia (OS) is a geriatric syndrome characterized by low muscle mass and bone density. While a few studies have established the relationship between sarcopenia or osteoporosis and atrial fibrillation (AF), the association between OS and incident AF has not yet been evaluated. Purpose To investigate the association between OS and the incidence AF Methods Using the UK Biobank database, participants without prior AF were categorized into four groups: normal, sarcopenia alone, osteoporosis alone, and both sarcopenia and osteoporosis as OS. The primary endpoint was incident AF over a median follow-up of 13.8 years. Results A total of 482,137 (aged 56.4 ± 8.1 years, 45.2% male) were analyzed. The prevalence of OS in the study population was 0.65%; the OS group had a higher prevalence of comorbidities, including hypertension, diabetes mellitus, dyslipidemia, and a history of myocardial infarction, heart failure, and stroke. Each sarcopenia and osteoporosis were associated with an increased risk of AF (aHR of 1.06 95% CI 1.01 - 1.12 and aHR of 1.25 95% CI 1.10 - 1.43, respectively). OS was significantly associated with the increased risk of incidence of AF, aHR of 1.40 (95% CI 1.15 - 1.70). OS had a superior prognostic value for incident AF than the CHARGE-AF score (the category-free NRI of 27.2% [95% CI 0.260-0.284)). Conclusion OS was significantly associated with an increased risk of incident AF and demonstrated superior predictive value for AF incidence compared to the CHARGE-AF score. Screening and proper management of OS in the general population could help reduce the global burden of AF.