Nonalcoholic fatty liver disease and the risk of atrial fibrillation stratified by body mass index: a nationwide population-based study

Lee

Front. Cardiovasc. Med.

et al. 2022

Self Cite

BackgroundNon-alcoholic fatty liver disease (NAFLD) is a multisystem disease including cardiovascular. However, the association between NAFLD and the risk of incident atrial fibrillation (AF), especially in young adults, remains unclear. We aimed to evaluate the association between NAFLD as assessed by the fatty liver index (FLI) and the risk of AF in young adults.MethodsWe identified individuals aged 20–39 years who underwent health examinations conducted by the Korean National Health Insurance Corporation between January 2009 and December 2012. Individuals with significant liver disease, heavy alcohol consumption, or prevalent AF were excluded. We categorized based on FLI: <30, 30 to <60, and ≥60. Incident AF was evaluated as the primary outcome.ResultsWe included 5,333,907 subjects (mean age, 31 ± 5 years; men, 57%). During a mean follow-up of 7.4 ± 1.1 years, 12,096 patients had newly diagnosed AF (incidence rate 0.31 per 1,000 person-years). After adjustment, subjects with FLI 30 to <60 and FLI ≥60 showed a higher risk of AF compared to those with FLI <30 (hazard ratio [HR] 1.21, 95% confidence interval [CI, 1.15–1.27] and HR 1.47, 95% CI [1.39–1.55], p < 0.001, respectively). In women, the increased AF risk was accentuated in the higher FLI group than in the individuals with FLI <30, compared with men (p-for-interaction = 0.023). A higher incident AF risk in the higher FLI groups was consistently observed in various subgroups.ConclusionAmong young adults, NAFLD assessed using FLI was positively correlated with the AF risk. These findings support the evidence of AF screening in young adults with high FLI scores.

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Non-alcoholic Fatty Liver Disease and the Risk of Incident Atrial Fibrillation in Young Adults: A Nationwide Population-Based Cohort Study

Lee

Front. Cardiovasc. Med.

et al. 2022

Self Cite

“…Therefore, 19 eligible observational studies remained and were included in the meta-analysis. 19 – 36 …”

Section: Resultsmentioning

confidence: 99%

Relationship between non-alcoholic fatty liver disease and cardiac arrhythmia: a systematic review and meta-analysis

2021

Objective We performed a meta-analysis to create a quantitative estimate of the association between non-alcoholic fatty liver disease (NAFLD) and the risk of cardiac arrhythmia (including atrial fibrillation (AF), prolonged QT interval, premature atrial/ventricular contraction [PAC/PVC] and heart block). Methods A literature review was conducted using PubMed, Embase, Web of Science and the Cochrane Library database to identify observational studies of the link between NAFLD and cardiac arrhythmia. Effect sizes were expressed as odds ratios (ORs) or hazard ratios (HRs) with 95% confidence intervals (CIs). The method of analysis of AF was also analysed separately, according to the effect estimate (OR or HR). Results Nineteen studies of 7,012,960 individuals were included. NAFLD was independently associated with higher risks of AF (OR 1.71, 95% CI: 1.14–2.57; HR 1.12, 95% CI: 1.11–1.13), prolonged QT interval (OR 2.86, 95% CI: 1.64–4.99), PAC/PVC (OR 2.53, 95% CI: 1.70–3.78) and heart block (OR 2.65, 95% CI: 1.88–3.72). The heterogeneity of the data with respect to AF and prolonged QT was moderate on sensitivity analysis. Conclusions We found a significantly higher risk of cardiac arrhythmia in patients with NAFLD, but the observational design of the studies does not permit conclusions regarding causality.

“…The de nition of exercise is (1) moderate physical activity for > 30 min, ≥ 1 time/week or (2) vigorous physical activity for > 20 min, ≥ 1 time/week. And regular exercise is (1) moderate physical activity for > 30 min, ≥ 5 times/week or (2) vigorous physical activity for > 20 min, ≥ 3 times/week 27 .…”

Section: Measurement Of General Health Behaviors and Comorbiditiesmentioning

confidence: 99%

Association Between Knee Osteoarthritis and the Risk of Cardiovascular Disease and the Synergistic Adverse Effects of Lack of Exercise

Park

et al. 2022

Preprint

Objectives: We aimed to determine whether knee OA is associated with CVD risk and to evaluate whether the association differs by exercise behavior. Methods: We used Korea National Health Insurance Service (KNHIS) database and included 201,466 participants (7,572 subjects diagnosed with knee OA) who underwent health screening between 2009 and 2015. Those who had been diagnosed with knee OA or CVD before the index year were excluded. Cox proportional hazard models were used after adjusting for sociodemographic and CVD risk factors to evaluate the association between knee OA and CVD risk. Stratification analysis was further performed to determine the effect of exercise behavior on this relationship. Results: During a median follow-up of 7.06 ± 2.24 years, 8,743 CVD (2,510 MI and 6,553 stroke) cases developed. Individuals with knee OA had increased risks of CVD (hazard ratio (HR) 1.26, 95% confidence interval (CI) 1.15–1.38), myocardial infarction (MI) (HR 1.20, 95% CI 1.00–1.44), and stroke (HR 1.29, 95% CI 1.16–1.43) compared with those without knee OA. Those with knee OA who did not exercise had an increased risk of CVD (HR 1.25, 95% CI 1.11-1.40), whereas no significant increased CVD risk was observed in those with knee OA who exercised at least once a week (HR 1.11, 95% CI 0.96-1.28). Conclusion: Knee OA was independently associated with an increased risk of CVD. Lack of exercise might have a synergistic adverse effect on the association between knee OA and CVD.