Association of metabolic syndrome and chronic kidney disease with atrial fibrillation: A nationwide population-based study in Korea

Choe, Won Seok; Choi, Eue Keun; Han, Kyung Do; Lee, Eui Jae; Lee, So‐Ryoung; Jin, Myung; Oh, Seil

doi:10.1016/j.diabres.2018.12.004

Cited by 24 publications

(22 citation statements)

References 26 publications

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“…Figure 1 shows the literature search process. Among 335 articles identified from the databases, we included 6 studies for analysis, including 4 prospective cohorts [8,10,12,13] and 2 retrospective cohorts [9,11], which described their results with HRs. Table 1 summarizes the patients characteristics of the included studies.…”

Section: Discussionmentioning

confidence: 99%

“…Prior studies have found that the prevalence of AF increases in parallel with the frequency of MetS [7]. Epidemiological studies conducted in Asian population samples [8][9][10][11] and Western population samples [12,13] showed that patients with MetS are more likely to have AF than patients without MetS. In addition, the increase in the number of components of the MetS is related to the occurrence of AF [14].…”

Section: Introductionmentioning

confidence: 98%

“…In addition, the increase in the number of components of the MetS is related to the occurrence of AF [14]. Despite the relatively large amount of evidence, there are differences in the estimates of the studies above, so we cannot assess the extent to which the MetS and its components affect AF [8][9][10][11][12][13]. Therefore, we conducted a systematic review and metaanalysis to observe the impact of MetS or its individual components on the incidence of AF.…”

Section: Introductionmentioning

confidence: 99%

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Meta-analysis of metabolic syndrome and its individual components with risk of atrial fibrillation in different populations

Zheng¹,

Xie²,

Li³

et al. 2021

BMC Cardiovasc Disord

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Background Recent studies have reported the effects of metabolic syndrome (MetS) and its components on atrial fibrillation (AF), but the results remain controversial. Therefore, we performed a meta-analysis to evaluate the relationship between MetS and AF risk. Methods Studies were searched from the Cochrane library, PubMed, and Embase databases through May 2020. Adjusted hazard ratios (HRs) and its corresponding 95% confidence intervals (CIs) were extracted and then pooled by using a random effects model. Results A total of 6 observational cohort studies were finally included. In the pooled analysis, MetS was associated with an increased risk of AF (HR 1.57; 95% CI 1.40–1.77; P < 0.01). And the components of MetS including abdominal obesity (HR 1.37; 95% CI 1.36–1.38; P < 0.01), elevated blood pressure (HR 1.56; 95% CI 1.46–1.66; P < 0.01), elevated fasting glucose (HR 1.18; 95% CI 1.15–1.21; P < 0.01) and low high density cholesterol (HDL) (HR 1.18; 95% CI 1.06–1.32; P < 0.01) was also associated with an increased risk of AF, while high triglyceride (HR 0.99; 95% CI 0.87–1.11, P = 0.82) was not. Conclusions Our present meta-analysis suggested that MetS, as well as its components including abdominal obesity, elevated blood pressure, elevated fasting glucose and low HDL cholesterol were associated with an increase in the risk of AF.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Meta-analysis of metabolic syndrome and its individual components with risk of atrial fibrillation in different populations

Zheng¹,

Xie²,

Li³

et al. 2021

BMC Cardiovasc Disord

View full text Add to dashboard Cite

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“…Atrial fibrillation is associated with heart failure, obesity, diabetes, hypertension, and hyperthyroidism [9]. Obesity has been shown to be an independent risk factor for AF [10], and this association has been observed in multiples studies thus far [11][12][13]. Wang et al [11], analyzed the data of the Framingham Heart Study, a long-standing, multigenerational, longitudinal study of cardiovascular disease, and found that body mass index (BMI) independently predicted AF when adjusted for other risk factors [11].…”

Section: Obesity and Metabolic Syndromementioning

confidence: 99%

The Role of Cardiovascular and Metabolic Comorbidities in the Link between Atrial Fibrillation and Cognitive Impairment: An Appraisal of Current Scientific Evidence

et al. 2019

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Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice with implications on long-term outcomes. Metabolic disorders including diabetes mellitus and obesity are independent predictors of atrial fibrillation and present therapeutic targets to reduce both the incidence and duration burden of atrial fibrillation. The presence of pericardial fat in direct contact with cardiac structures, as well the subsequent release of proinflammatory cytokines, may play an important role in this connection. Atrial fibrillation is an independent predictor of cognitive impairment and dementia. While clinical stroke is a major contributor, other factors such as cerebral hypoperfusion and microbleeds play important roles. New evidence suggests that atrial fibrillation and cognitive impairment may be downstream events of atrial cardiomyopathy, which may be caused by several factors including metabolic syndrome, obesity, and obstructive sleep apnea. The mechanisms linking these comorbidities to cognitive impairment are not yet fully elucidated. A clearer understanding of the association of AF with dementia and cognitive impairment is imperative. Future studies should focus on the predictors of cognitive impairment among those with AF and aim to understand the potential mechanisms underlying these associations. This would inform strategies for the management of AF aiming to prevent continued cognitive impairment.

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“…People who develop type 2 diabetes usually pass through earlier stages of prediabetes and IR, although these stages are often undiagnosed. Metabolic syndrome and IR have been suggested as risk factors for incident AF, but they have not been supported by all clinical observations [5–9]. Previous studies have demonstrated the pathological mechanisms of overt hyperglycemia-related atrial remodeling and arrhythmogenesis in animal models of diabetes [10, 11].…”

Section: Introductionmentioning

confidence: 99%

Atrial fibrillation and its arrhythmogenesis associated with insulin resistance

Chan

Chang

Lai

et al. 2019

Cardiovasc Diabetol

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Background Insulin resistance (IR) is considered as a risk factor for atrial fibrillation (AF) even before diabetes develops. The pathophysiology and underlying mechanism are largely unclear. Methods We investigated the corresponding mechanism in two IR models of rats fed 15-week high-fat (HFa) and high-fructose/cholesterol (HFr) diets. AF was evaluated and induced by burst atrial pacing. Isolated atrial myocytes were used for whole-cell patch clamp and calcium assessment. Ex vivo whole heart was used for optical mapping. Western blot and immunofluorescence were used for quantitative protein evaluation. Results Both HFa and HFr rat atria were vulnerable to AF evaluated by burst atrial pacing. Isolated atrial myocytes from HFa and HFr rats revealed significantly increased sarcoplasmic reticulum calcium content and diastolic calcium sparks. Whole-heart mapping showed prolonged calcium transient duration, conduction velocity reduction, and repetitive ectopic focal discharge in HFa and HFr atria. Protein analysis revealed increased TGF-β1 and collagen expression; increased superoxide production; abnormal upregulation of calcium-homeostasis-related proteins, including oxidized CaMKIIδ, phosphorylated-phospholamban, phosphorylated-RyR-2, and sodium-calcium exchanger; and increased Rac1 activity in both HFa and HFr atria. We observed that inhibition of CaMKII suppressed AF in both HF and HFr diet-fed rats. In vitro palmitate-induced IR neonatal cardiomyocytes and atrial fibroblasts expressed significantly more TGF-β1 than did controls, suggesting paracrine and autocrine effects on both myocytes and fibroblasts. Conclusions IR engenders both atrial structural remodeling and abnormal intracellular calcium homeostasis, contributing to increased AF susceptibility. The inhibition of CaMKII may be a potential therapeutic target for AF in insulin resistance.

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Association of metabolic syndrome and chronic kidney disease with atrial fibrillation: A nationwide population-based study in Korea

Cited by 24 publications

References 26 publications

Meta-analysis of metabolic syndrome and its individual components with risk of atrial fibrillation in different populations

Meta-analysis of metabolic syndrome and its individual components with risk of atrial fibrillation in different populations

The Role of Cardiovascular and Metabolic Comorbidities in the Link between Atrial Fibrillation and Cognitive Impairment: An Appraisal of Current Scientific Evidence

Atrial fibrillation and its arrhythmogenesis associated with insulin resistance

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