Atrial fibrillation and its association with type 2 diabetes and hypertension in a Swedish community
Atrial fibrillation and its association with type 2 diabetes and hypertension in a Swedish community
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DOI：
10.1111/j.1462-8902.2004.00358.x
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发表时间：
2004-09-01
影响因子：
5.8
通讯作者：
Lindblad, U
中科院分区：
文献类型：
--
作者：
Östgren, CJ;Merlo, J;Lindblad, U
目的：探讨高血压和 2 型糖尿病患者心房颤动的患病率，并确定心房颤动发生的可能机制。方法：在瑞典斯卡拉的初级卫生保健机构中开展了一项基于社区的横断面观察性研究，对 1739 名受试者（798 名男性，941 名女性）进行了调查。患者被归类为仅患有高血压的患者（n = 597）；同时患有高血压和 2 型糖尿病的患者 (n = 171)，以及仅患有 2 型糖尿病的患者 (n = 147)。在参考人群中，确定了 824 名血压正常、无糖尿病的受试者并将其用作对照。检查参与者的心血管危险因素，包括空腹血糖、血清胰岛素、血压、血脂和人体测量指标。记录静息心电图 (ECG) 并进行明尼苏达编码。通过稳态模型评估（HOMA）测量胰岛素抵抗。结果：仅患有高血压的患者中房颤的年龄调整患病率为2％，患有高血压和2型糖尿病的患者为6％，仅患有2型糖尿病的患者为4％，对照组为2％。年龄和性别调整后的比值比 (OR) (95% CI) 为：高血压 0.7 (0.30-1.5)，合并高血压和 2 型糖尿病 3.3 (1.6-6.7)，以及 2 型糖尿病 2.0 (0.9-4.7)。在调整心血管疾病 (CVD) 危险因素和体重指数 (BMI) 后，与高血压和 2 型糖尿病合并的关联仍然显着，但在调整缺血性心电图后减弱； 2.4 (1.1-5.0)，并且在调整胰岛素抵抗后失去显着性； 1.3（0.5-3.1）。结论：心房颤动与2型糖尿病和高血压合并发生有关。胰岛素抵抗可能是一种常见的潜在机制。
Aim: To explore the prevalence of atrial fibrillation in patients with hypertension and type 2 diabetes and to identify possible mechanisms for the development of atrial fibrillation.Methods: A community-based, cross-sectional observational study was conducted in the primary health care in Skara, Sweden, and 1739 subjects (798 men, 941 women) were surveyed. Patients were categorized as those with hypertension only (n = 597); those with both hypertension and type 2 diabetes (n = 171), and those with type 2 diabetes only (n = 147). In the reference population, 824 normotensive subjects without diabetes were identified and used as controls. Participants were examined for cardiovascular risk factors including fasting blood glucose, serum insulin, blood pressure, lipids and anthropometric measures. Resting electrocardiogram (ECG) was recorded and Minnesota-coded. Insulin resistance was measured by the homeostasis model assessment (HOMA).Results: Age-adjusted prevalence of atrial fibrillation was 2% in patients with hypertension only, 6% in patients with both hypertension and type 2 diabetes, 4% in patients with type 2 diabetes only and 2% in controls, respectively. Age and sex adjusted odds ratios (OR) (95% CI) were; hypertension 0.7 (0.30-1.5), combined hypertension and type 2 diabetes 3.3 (1.6-6.7), and type 2 diabetes 2.0 (0.9-4.7). The association with combined hypertension and type 2 diabetes remained significant when adjusted for cardiovascular disease (CVD) risk factors and body mass index (BMI), was attenuated with adjustment for ischemic ECG; 2.4 (1.1-5.0) and lost significance with adjustment for insulin resistance; 1.3 (0.5-3.1).Conclusions: Atrial fibrillation is associated with the combined occurrence of type 2 diabetes and hypertension. Insulin resistance may be a common underlying mechanism.