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Sci Rep. 2021;11(1):3737.

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

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제1저자 이소령, 한경도 · 교신저자 최의근

PMID 33580177 PMC7881181 DOI 10.1038/s41598-021-83367-x IF 4.9 순환기내과
소속 (5)
  1. Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
  2. Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea.
  3. Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. choiek17@snu.ac.kr.
  4. Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Chest & Heart Hospital, Liverpool, UK.
  5. Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.

Abstract

We evaluated the association between nonalcoholic fatty liver disease (NAFLD) and incident atrial fibrillation (AF) and analyzed the impact of NAFLD on AF risk in relation to body mass index (BMI). A total of 8,048,055 subjects without significant liver disease who were available fatty liver index (FLI) values were included. Subjects were categorized into 3 groups based on FLI: < 30, 30 to < 60, and ≥ 60. During a median 8-year of follow-up, 534,442 subjects were newly diagnosed as AF (8.27 per 1000 person-years). Higher FLI was associated with an increased risk of AF (hazard ratio [HR] 1.053, 95% confidence interval [CI] 1.046-1.060 in 30 ≤ FLI < 60, and HR 1.115, 95% CI 1.106-1.125 in FLI ≥ 60). In underweight subjects (BMI < 18.5 kg/m2), higher FLI raised the risk of AF (by 1.6-fold in 30 ≤ FLI < 60 and by twofold in FLI ≥ 60). In normal- and overweight subjects, higher FLI was associated with an increased risk of AF, but the HRs were attenuated. In obese subjects, higher FLI was not associated with higher risk of AF. NAFLD as assessed by FLI was independently associated with an increased risk of AF in nonobese subjects with BMI < 25 kg/m2. The impact of NAFLD on AF risk was accentuated in lean subjects with underweight.

Figures

Figure 1
Figure 1 Study enrollment flow. *Liver disease: obvious liver disease such as liver cirrhosis (ICD-10 codes, K703 and K76) and hepatitis (ICD-10 codes, B15–B19), (v) existing cancer (ICD-10 codes, C00-96).
Figure 2
Figure 2 Cumulative incidence curves of AF stratified by fatty liver index in different BMI groups: underweight (BMI < 18.5 kg/m2), normal weight (BMI 18.5–23 kg/m2), overweight (BMI 23–25 kg/m2), obese I (BMI 25–30 kg/m2), and obese II (BMI ≥ 30 kg/m2). AF atrial fibrillation, BMI body mass index, FLI fatty liver index.
Figure 3
Figure 3 Hazard ratios of the FLI for incident AF in different BMI groups. *Adjusted HR: Model 3 (age, sex, hypertension, diabetes, dyslipidemia, chronic kidney disease, smoking, alcohol consumption, exercise, low income, systolic blood pressure, total cholesterol, and fasting glucose). AF atrial fibrillation, BMI body mass index, CI confidence interval, FLI fatty liver index, HR hazard ratio.

그림 출처: PubMed Central 공개 논문 (PMC7881181)

Conflict of interest statement

E-K.C.: Research grant from Sanofi-Aventis, Chong Kun Dang, Daiichi-Sankyo, BMS/Pfizer, Biosense Webster, and Skylabs. G.Y.H.L.: Consultant for Bayer/Janssen, BMS/Pfizer, Medtronic, Boehringer Ingelheim, Novartis, Verseon and Daiichi-Sankyo. Speaker for Bayer, BMS/Pfizer, Medtronic, Boehringer Ingelheim, and Daiichi-Sankyo. No fees are received personally. The other authors declare no competing interests.

그 밖의 정보
출판 형태
Journal Article, Research Support, Non-U.S. Gov't
저널
Scientific reports · eISSN 2045-2322
전자 출판
2021-02-12
MeSH
Adult · Atrial Fibrillation / etiology / physiopathology · Body Mass Index · Body Weight / physiology · Databases, Factual · Female · Humans · Liver Function Tests · Male · Middle Aged · Non-alcoholic Fatty Liver Disease / complications / physiopathology · Obesity / complications · Republic of Korea / epidemiology · Risk Factors · Thinness / complications · Waist Circumference
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