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Obesity commonly accompanies T2DM, and increases the risk of AF. However, the dose-relationship between body mass index (BMI) and AF risk has seldom been studied in patients with diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cohort study utilized a database from National Taiwan University Hospital, a tertiary medical center in Taiwan. Between 2014 and 2019, 64,339 adult patients with T2DM were enrolled for analysis. BMI was measured and categorized as underweight (BMI\u2009&lt;\u200918.5), normal (18.5\u2009\u2264\u2009BMI\u2009&lt;\u200924), overweight (24\u2009\u2264\u2009BMI\u2009&lt;\u200927), obesity class 1 (27\u2009\u2264\u2009BMI\u2009&lt;\u200930), obesity class 2 (30\u2009\u2264\u2009BMI\u2009&lt;\u200935), or obesity class 3 (BMI\u2009\u2265\u200935). Multivariate Cox regression and spline regression models were employed to estimate the relationship between BMI and the risk of AF in patients with T2DM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The incidence of AF was 1.97 per 1000 person-years (median follow-up, 70.7\u00a0months). In multivariate Cox regression, using normal BMI as the reference group, underweight (HR 1.52, 95% CI 1.25\u20131.87,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) was associated with a significantly higher risk of AF, while overweight was associated with significantly reduced risk of AF (HR 0.82, 95% CI 0.73\u20130.89,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Kaplan\u2013Meier analysis showed AF risk was highest in the underweight group, followed by obesity class 3, while the overweight group had the lowest incidence of AF (log-rank test,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The cubic restrictive spline model revealed a \u201cJ-shaped\u201d or \u201cL-shaped\u201d relationship between BMI and AF risk.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Underweight status confers the highest AF risk in Asian patients with T2DM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12933-021-01415-2","type":"journal-article","created":{"date-parts":[[2021,11,24]],"date-time":"2021-11-24T10:02:51Z","timestamp":1637748171000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Underweight is a major risk factor for atrial fibrillation in Asian people with type 2 diabetes mellitus"],"prefix":"10.1186","volume":"20","author":[{"given":"Jung-Chi","family":"Hsu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yen-Yun","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu-Lin","family":"Chuang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Wei","family":"Chung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Hsien","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9281-1171","authenticated-orcid":false,"given":"Lian-Yu","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,11,24]]},"reference":[{"issue":"3","key":"1415_CR1","doi-asserted-by":"publisher","first-page":"476","DOI":"10.1016\/j.diabres.2015.06.006","volume":"109","author":"L Staszewsky","year":"2015","unstructured":"Staszewsky L, Cortesi L, Baviera M, Tettamanti M, Marzona I, Nobili A, et al. 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