Journal Article

Non-Alcoholic Fatty Liver Disease Is Associated with an Increased Incidence of Atrial Fibrillation in Patients with Type 2 Diabetes

Bertolini, Lorenzo, Valbusa, Filippo, Zoppini, Giacomo, Mantovani, William, Barbieri, Enrico, Targher, Giovanni, Rodella, Stefano, Bonapace, Stefano, Zenari, Luciano, Byrne, Christopher D.

2013

Overview

The relationship between non-alcoholic fatty liver disease (NAFLD) and atrial fibrillation (AF) in type 2 diabetes is currently unknown. We examined the relationship between NAFLD and risk of incident AF in people with type 2 diabetes. We prospectively followed for 10 years a random sample of 400 patients with type 2 diabetes, who were free from AF at baseline. A standard 12-lead electrocardiogram was undertaken annually and a diagnosis of incident AF was confirmed in affected participants by a single cardiologist. At baseline, NAFLD was defined by ultrasonographic detection of hepatic steatosis in the absence of other liver diseases. During the 10 years of follow-up, there were 42 (10.5%) incident AF cases. NAFLD was associated with an increased risk of incident AF (odds ratio [OR] 4.49, 95% CI 1.6-12.9, p<0.005). Adjustments for age, sex, hypertension and electrocardiographic features (left ventricular hypertrophy and PR interval) did not attenuate the association between NAFLD and incident AF (adjusted-OR 6.38, 95% CI 1.7-24.2, p = 0.005). Further adjustment for variables that were included in the 10-year Framingham Heart Study-derived AF risk score did not appreciably weaken this association. Other independent predictors of AF were older age, longer PR interval and left ventricular hypertrophy. Our results indicate that ultrasound-diagnosed NAFLD is strongly associated with an increased incidence of AF in patients with type 2 diabetes even after adjustment for important clinical risk factors for AF.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Aged / Atrial Fibrillation - complications / Biology / Cardiac arrhythmia / Cardiology / Cardiovascular disease / Care and treatment / Confidence intervals / Diabetes / Diabetes mellitus / Diabetes Mellitus, Type 2 - complications / EKG / Electrocardiography / Endocrinology / Fatty liver / Fatty Liver - complications / Fatty Liver - diagnostic imaging / Female / Fibrillation / Heart / Heart failure / Hospitals / Humans / Hypertension / Hypertrophy / Incidence / Incidental Findings / Liver / Liver diseases / Male / Medicine / Metabolism / Middle Aged / Non-alcoholic Fatty Liver Disease / Patients / Population / Prospective Studies / Public health / Risk analysis / Risk factors / Sample size / Steatosis / Type 2 diabetes / Ultrasonography / Ultrasound / Ventricle