The Impact of Metabolic Syndrome on the Incidence of Atrial Fibrillation: A Nationwide Longitudinal Cohort Study in South Korea.

Kwon Kwon,Dong Sung Dong Sung,Ryu Ryu,Kim Kim,Han Han

doi:10.3390/jcm8081095

Abstract

Aims: To evaluate the impact of metabolic syndrome (MetS) status on the incidence of atrial fibrillation (AF) in Koreans. Methods and results: Data obtained from the Korean National Health Insurance Service from 2009 to 2016 were analyzed. In total, 7,830,602 men and women (between 30 and 69 years of age) without baseline AF who underwent a national health examination between January 2009 and December 2009 were enrolled. Patients were evaluated to determine the impact of MetS status on their risk of developing AF until December 2016. Using the National Cholesterol Education Program Adult Treatment Panel III criteria, patients were placed into one of three groups depending on MetS component numbers: 0 (normal), 1–2 (Pre-MetS) or 3–5 (MetS). During a mean follow-up of 7.3 years, 20,708 subjects (0.26%) were diagnosed with AF. After multivariable adjustment, the risk of AF was significantly and positively correlated with MetS status (hazard ratios (HR) 1.391, 95% confidence interval (CI) 1.322–1.464 in Pre-MetS and HR 1.722, 95% CI 1.621–1.829 in MetS). When subgroup analyses were conducted according to MetS components, abdominal obesity (HR 1.316, p < 0.001), elevated blood pressure (HR 1.451, p < 0.001), and elevated fasting glucose (HR 1.163, p < 0.001) were associated with an increased risk of AF. Conclusion: MetS and pre-MetS are significantly associated with an increased risk of AF in Korean adults. Of the MetS components, abdominal obesity, elevated blood pressure, and elevated fasting glucose are potent risk factors for the risk of AF in this population.

Highlights

Atrial fibrillation (AF) is the most common cardiac arrhythmia and is independently associated with increased risks of mortality and morbidity [1,2,3]
Previous studies have reported that Metabolic syndrome (MetS) is associated with an increased risk of atrial fibrillation (AF) [13,14,15,16], these studies were conducted using: (i) western populations [14,15], (ii) body mass index (BMI) in place of waist circumference (WC) for abdominal obesity [13], and (iii) populations of only middle-aged men [16]
In this nationwide longitudinal cohort study, we used the Korean National Health Insurance Service (NHIS) database to assess the association between MetS status and incidence of AF among the general population

Summary

Introduction

Atrial fibrillation (AF) is the most common cardiac arrhythmia and is independently associated with increased risks of mortality and morbidity [1,2,3]. Previous studies have reported that MetS is associated with an increased risk of AF [13,14,15,16], these studies were conducted using: (i) western populations [14,15], (ii) body mass index (BMI) in place of waist circumference (WC) for abdominal obesity [13], and (iii) populations of only middle-aged men [16]. In this nationwide longitudinal cohort study, we used the Korean National Health Insurance Service (NHIS) database to assess the association between MetS status and incidence of AF among the general population

Methods

Results

Discussion

Conclusion