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Dysregulated carbohydrate and lipid metabolism and risk of atrial fibrillation in advanced old age

Heart (British Cardiac Society), 2023-04, Vol.109 (8), p.606-611 [Peer Reviewed Journal]

Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ. ;2022 Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ. ;2023 Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ. ;ISSN: 1355-6037 ;EISSN: 1468-201X ;DOI: 10.1136/heartjnl-2022-321633 ;PMID: 36549682

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Title:
Dysregulated carbohydrate and lipid metabolism and risk of atrial fibrillation in advanced old age
Author: Pellegrini, Cara N ; Buzkova, Petra ; Oesterle, Adam ; Heckbert, Susan R ; Tracy, Russell P ; Siscovick, David S ; Mukamal, Kenneth J ; Djoussé, Luc ; Kizer, Jorge R
Subjects: Aged ; Aged, 80 and over ; Alcohol ; Antihypertensives ; Arrhythmias and sudden death ; atrial fibrillation ; Atrial Fibrillation - diagnosis ; Atrial Fibrillation - epidemiology ; Atrial Fibrillation - etiology ; Blood pressure ; Cardiac arrhythmia ; Cardiovascular disease ; Diabetes ; Electrocardiography ; epidemiology ; Fatty acids ; Female ; Follow-Up Studies ; Glucose ; Hemoglobin ; Humans ; Incidence ; Insulin resistance ; Laboratories ; Lipid Metabolism ; Male ; Metabolism ; Middle age ; Older people ; Prospective Studies ; Risk Factors ; Womens health
Is Part Of: Heart (British Cardiac Society), 2023-04, Vol.109 (8), p.606-611
Description: ObjectiveObesity and dysmetabolism are major risk factors for atrial fibrillation (AF). Fasting and postload levels of glucose and non-esterified fatty acids (NEFAs) reflect different facets of metabolic regulation. We sought to study their respective contributions to AF risk concurrently.MethodsWe assessed levels of fasting and postload glucose and NEFA in the Cardiovascular Health Study to identify associations with AF incidence and, secondarily, with ECG parameters of AF risk available at baseline. Linear and Cox regressions were performed.ResultsThe study included 1876 participants (age 77.7±4.4). During the median follow-up of 11.4 years, 717 cases of incident AF occurred. After adjustment for potential confounders, postload glucose showed an association with incident AF (HR per SD increment of postload glucose=1.11, 95% CI 1.02 to 1.21, p=0.017). Both glucose measures, but not NEFA, were positively associated with higher P wave terminal force in V1 (PTFV1); the association remained significant only for postload glucose when the two measures were entered together (β per SD increment=138 μV·ms, 95% CI 15 to 260, p=0.028). Exploratory analyses showed significant interaction by sex for fasting NEFA (pinteraction=0.044) and postload glucose (pinteraction=0.015) relative to AF, with relationships stronger in women. For postload glucose, the association with incident AF was observed among women but not among men.ConclusionsAmong older adults, postload glucose was positively associated with incident AF, with consistent findings for PTFV1. In exploratory analyses, the relationship with AF appeared specific to women. These findings require further study but suggest that interventions to address postprandial dysglycaemia late in life might reduce AF.
Publisher: England: BMJ Publishing Group Ltd and British Cardiovascular Society
Language: English
Identifier: ISSN: 1355-6037
EISSN: 1468-201X
DOI: 10.1136/heartjnl-2022-321633
PMID: 36549682
Source: MEDLINE
ProQuest Central

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Dysregulated carbohydrate and lipid metabolism and risk of atrial fibrillation in advanced old age

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