Cumulative burden of metabolic syndrome and its components on the risk of atrial fibrillation: a nationwide population-based study
Abstract Background The metabolic syndrome (MetS) and its components are associated with the development of atrial fibrillation (AF). However, the impact of time-burden of MetS on the risk of AF is unknown. We investigated the effect of the cumulative longitudinal burden of MetS on the development o...
Main Authors: | , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMC
2021-01-01
|
Series: | Cardiovascular Diabetology |
Subjects: | |
Online Access: | https://doi.org/10.1186/s12933-021-01215-8 |
id |
doaj-faf3874cc65e43abb34fd2181ca760f1 |
---|---|
record_format |
Article |
spelling |
doaj-faf3874cc65e43abb34fd2181ca760f12021-01-24T12:23:29ZengBMCCardiovascular Diabetology1475-28402021-01-0120111310.1186/s12933-021-01215-8Cumulative burden of metabolic syndrome and its components on the risk of atrial fibrillation: a nationwide population-based studyHyo-Jeong Ahn0Kyung-Do Han1Eue-Keun Choi2Jin-Hyung Jung3Soonil Kwon4So-Ryoung Lee5Seil Oh6Gregory Y. H. Lip7Department of Internal Medicine, Seoul National University HospitalDepartment of Statistics and Actuarial Science, Soongsil UniversityDepartment of Internal Medicine, Seoul National University HospitalDepartment of Medical Statistics, College of Medicine, The Catholic University of KoreaDepartment of Internal Medicine, Seoul National University HospitalDepartment of Internal Medicine, Seoul National University HospitalDepartment of Internal Medicine, Seoul National University HospitalDepartment of Internal Medicine, Seoul National University College of MedicineAbstract Background The metabolic syndrome (MetS) and its components are associated with the development of atrial fibrillation (AF). However, the impact of time-burden of MetS on the risk of AF is unknown. We investigated the effect of the cumulative longitudinal burden of MetS on the development of AF. Methods We included 2 885 189 individuals without AF who underwent four annual health examinations during 2009–2013 from the database of the Korean national health insurance service. Metabolic burdens were evaluated in the following three ways: (1) cumulative number of MetS diagnosed at each health examination (0–4 times); (2) cumulative number of each MetS component diagnosed at each health examination (0–4 times per MetS component); and (3) cumulative number of total MetS components diagnosed at each health examination (0 to a maximum of 20). The risk of AF according to the metabolic burden was estimated using Cox proportional-hazards models. Results Of all individuals, 62.4%, 14.8%, 8.7%, 6.5%, and 7.6% met the MetS diagnostic criteria 0, 1, 2, 3, and 4 times, respectively. During a mean follow-up of 5.3 years, the risk of AF showed a positive association with the cumulative number of MetS diagnosed over four health examinations: adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) of 1, 2, 3, and 4 times compared to 0 times were 1.18 (1.13–1.24), 1.31 (1.25–1.39), 1.46 (1.38–1.55), and 1.72 (1.63–1.82), respectively; P for trend < 0.001. All five components of MetS, when diagnosed repeatedly, were independently associated with an increased risk of AF: adjusted HR (95% CI) from 1.22 (1.15–1.29) for impaired fasting glucose to 1.96 (1.87–2.07) for elevated blood pressure. As metabolic components were accumulated from 0 to 20 counts, the risk of AF also gradually increased up to 3.1-fold (adjusted HR 3.11, 95% CI 2.52–3.83 in those with 20 cumulative components of MetS), however, recovery from MetS was linked to a decreased risk of AF. Conclusions Given the positive correlations between the cumulative metabolic burdens and the risk of incident AF, maximal effort to detect and correct metabolic derangements even before MetS development might be important to prevent AF and related cardiovascular diseases.https://doi.org/10.1186/s12933-021-01215-8Metabolic syndromeMetabolic burdenAtrial fibrillation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Hyo-Jeong Ahn Kyung-Do Han Eue-Keun Choi Jin-Hyung Jung Soonil Kwon So-Ryoung Lee Seil Oh Gregory Y. H. Lip |
spellingShingle |
Hyo-Jeong Ahn Kyung-Do Han Eue-Keun Choi Jin-Hyung Jung Soonil Kwon So-Ryoung Lee Seil Oh Gregory Y. H. Lip Cumulative burden of metabolic syndrome and its components on the risk of atrial fibrillation: a nationwide population-based study Cardiovascular Diabetology Metabolic syndrome Metabolic burden Atrial fibrillation |
author_facet |
Hyo-Jeong Ahn Kyung-Do Han Eue-Keun Choi Jin-Hyung Jung Soonil Kwon So-Ryoung Lee Seil Oh Gregory Y. H. Lip |
author_sort |
Hyo-Jeong Ahn |
title |
Cumulative burden of metabolic syndrome and its components on the risk of atrial fibrillation: a nationwide population-based study |
title_short |
Cumulative burden of metabolic syndrome and its components on the risk of atrial fibrillation: a nationwide population-based study |
title_full |
Cumulative burden of metabolic syndrome and its components on the risk of atrial fibrillation: a nationwide population-based study |
title_fullStr |
Cumulative burden of metabolic syndrome and its components on the risk of atrial fibrillation: a nationwide population-based study |
title_full_unstemmed |
Cumulative burden of metabolic syndrome and its components on the risk of atrial fibrillation: a nationwide population-based study |
title_sort |
cumulative burden of metabolic syndrome and its components on the risk of atrial fibrillation: a nationwide population-based study |
publisher |
BMC |
series |
Cardiovascular Diabetology |
issn |
1475-2840 |
publishDate |
2021-01-01 |
description |
Abstract Background The metabolic syndrome (MetS) and its components are associated with the development of atrial fibrillation (AF). However, the impact of time-burden of MetS on the risk of AF is unknown. We investigated the effect of the cumulative longitudinal burden of MetS on the development of AF. Methods We included 2 885 189 individuals without AF who underwent four annual health examinations during 2009–2013 from the database of the Korean national health insurance service. Metabolic burdens were evaluated in the following three ways: (1) cumulative number of MetS diagnosed at each health examination (0–4 times); (2) cumulative number of each MetS component diagnosed at each health examination (0–4 times per MetS component); and (3) cumulative number of total MetS components diagnosed at each health examination (0 to a maximum of 20). The risk of AF according to the metabolic burden was estimated using Cox proportional-hazards models. Results Of all individuals, 62.4%, 14.8%, 8.7%, 6.5%, and 7.6% met the MetS diagnostic criteria 0, 1, 2, 3, and 4 times, respectively. During a mean follow-up of 5.3 years, the risk of AF showed a positive association with the cumulative number of MetS diagnosed over four health examinations: adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) of 1, 2, 3, and 4 times compared to 0 times were 1.18 (1.13–1.24), 1.31 (1.25–1.39), 1.46 (1.38–1.55), and 1.72 (1.63–1.82), respectively; P for trend < 0.001. All five components of MetS, when diagnosed repeatedly, were independently associated with an increased risk of AF: adjusted HR (95% CI) from 1.22 (1.15–1.29) for impaired fasting glucose to 1.96 (1.87–2.07) for elevated blood pressure. As metabolic components were accumulated from 0 to 20 counts, the risk of AF also gradually increased up to 3.1-fold (adjusted HR 3.11, 95% CI 2.52–3.83 in those with 20 cumulative components of MetS), however, recovery from MetS was linked to a decreased risk of AF. Conclusions Given the positive correlations between the cumulative metabolic burdens and the risk of incident AF, maximal effort to detect and correct metabolic derangements even before MetS development might be important to prevent AF and related cardiovascular diseases. |
topic |
Metabolic syndrome Metabolic burden Atrial fibrillation |
url |
https://doi.org/10.1186/s12933-021-01215-8 |
work_keys_str_mv |
AT hyojeongahn cumulativeburdenofmetabolicsyndromeanditscomponentsontheriskofatrialfibrillationanationwidepopulationbasedstudy AT kyungdohan cumulativeburdenofmetabolicsyndromeanditscomponentsontheriskofatrialfibrillationanationwidepopulationbasedstudy AT euekeunchoi cumulativeburdenofmetabolicsyndromeanditscomponentsontheriskofatrialfibrillationanationwidepopulationbasedstudy AT jinhyungjung cumulativeburdenofmetabolicsyndromeanditscomponentsontheriskofatrialfibrillationanationwidepopulationbasedstudy AT soonilkwon cumulativeburdenofmetabolicsyndromeanditscomponentsontheriskofatrialfibrillationanationwidepopulationbasedstudy AT soryounglee cumulativeburdenofmetabolicsyndromeanditscomponentsontheriskofatrialfibrillationanationwidepopulationbasedstudy AT seiloh cumulativeburdenofmetabolicsyndromeanditscomponentsontheriskofatrialfibrillationanationwidepopulationbasedstudy AT gregoryyhlip cumulativeburdenofmetabolicsyndromeanditscomponentsontheriskofatrialfibrillationanationwidepopulationbasedstudy |
_version_ |
1724325958729596928 |