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Sci Rep. 2021;11(1):4676.

Lifestyle is associated with atrial fibrillation development in patients with type 2 diabetes mellitus.

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제1저자 박찬순, 한경도 · 교신저자 최의근

소속 (4)
  1. Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
  2. Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea.
  3. Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  4. Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. choiek17@snu.ac.kr.

Abstract

We evaluated the impacts of lifestyle behaviors, namely smoking, alcohol consumption, and physical activity, on the development of new-onset AF in patients with DM. Using the Korean Nationwide database, we identified subjects diagnosed with type 2 DM and without previous history of AF between 2009 and 2012. Self-reported lifestyle behaviors were analyzed. Among 2,551,036 included subjects, AF was newly diagnosed in 73,988 patients (median follow-up 7.1 years). Both ex-smokers (hazard ratio [HR] 1.05, 95% confidence interval [CI] 1.02-1.07) and current smokers (HR 1.06, 95% CI 1.03-1.08) demonstrated a higher risk of AF than never smokers. Patients with moderate (15-29 g/day) (HR 1.12, 95% CI 1.09-1.15) and heavy (≥ 30 g/day) (HR 1.24, 95% CI 1.21-1.28) alcohol consumption exhibited an increased risk of AF, while subjects with mild alcohol consumption (< 15 g/day) (HR 1.01, 95% CI 0.99-1.03) had an AF risk similar to that of non-drinkers. Patients who engaged in moderate-to-vigorous physical activity showed a lower risk of AF (HR 0.93, 95% CI 0.91-0.94) than those who did not. This study suggests that smoking, alcohol consumption, and physical activity are associated with new-onset AF in patients with DM, and lifestyle management might reduce the risk of AF in this population.

Figures

Figure 1
Figure 1 Clinical outcomes according to smoking, alcohol consumption, and physical activity. New-onset AF risk according to lifestyle behaviors in patients with DM. Data regarding lifestyle behaviors were collected during health check-ups as a self-reported questionnaire. AF atrial fibrillation, CI confidence interval, DM diabetes mellitus, HR hazard ratio, MVPA moderate-to-vigorous physical activity.
Figure 2
Figure 2 Relationship between lifestyle behaviors and new-onset AF according to sex. Subgroup analyses were performed to investigate the associations between smoking (A), alcohol consumption (B), and physical activity (C) and new-onset AF according to sex. Data regarding lifestyle behaviors were collected during health check-ups as a self-reported questionnaire. AF atrial fibrillation.
Figure 3
Figure 3 Subgroup analyses of the associations between lifestyle behaviors and new-onset AF. Subgroup analyses according to male (A) and female (B) are presented. Detailed stratification were additionally performed according to lifestyle behaviors. Smoking was categorized by pack-years, alcohol consumption by average daily alcohol consumption and weekly drinking frequency, and physical activity by the number of moderate- and vigorous-intensity exercise sessions per week. Data regarding lifestyle behaviors were collected during health check-ups as a self-reported questionnaire.
Figure 4
Figure 4 Associations between lifestyle behaviors and AF risk. The percentage of patients and HRs for adjusted AF risk stratified by lifestyle behaviors are presented. Patients who were never smokers, non-/mild drinkers, and engaged in MVPA were considered the reference group. Data regarding lifestyle behaviors were collected during health check-ups as a self-reported questionnaire. AF atrial fibrillation, HR hazard ratio, MVPA moderate-to-vigorous physical activity.

그림 출처: PubMed Central 공개 논문 (PMC7907194)

Conflict of interest statement

Eue-Keun Choi reports research grants from Bayer, BMS/Pfizer, Biosense Webster, Chong Kun Dang, Daiichi-Sankyo, Samjinpharm, Sanofi-Aventis, Seers Technology, Skylabs, and Yuhan. 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
2021-02-25
MeSH
Aged · Alcohol Drinking · Atrial Fibrillation / complications / etiology · Diabetes Mellitus, Type 2 / complications · Exercise · Female · Humans · Life Style* · Male · Middle Aged · Smoking
참고문헌
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