Dysregulated carbohydrate and lipid metabolism and risk of atrial fibrillation in advanced old age.
Dysregulated carbohydrate and lipid metabolism and risk of atrial fibrillation in advanced old age.
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DOI：
10.1136/heartjnl-2022-321633
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发表时间：
2023-03-27
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影响因子：
--
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肥胖和代谢异常是心房颤动（AF）的主要危险因素。葡萄糖和非酯化脂肪酸（NEFA）的空腹和负荷后水平反映了代谢调节的不同方面。我们试图同时研究它们各自对AF风险的贡献。我们在心血管健康研究中评估了空腹和负荷后血糖水平以及NEFA，以确定与AF发病率的相关性，其次是与基线时可用的AF风险ECG参数的相关性。进行线性和考克斯回归分析。该研究包括1，876名参与者（年龄77.7±4.4）。在11.4年的中位随访期间，发生了717例AF事件。调整潜在混杂因素后，负荷后血糖显示与AF事件相关（负荷后血糖每SD增量的HR =1.11 [95% CI=1.02，1.21]，p=0.017）。两种血糖测量值（NEFA除外）均与V1（PTFV 1）中较高的P波终末力呈正相关;当两种测量值一起输入时，仅负荷后血糖的相关性保持显著（β/SD增量=138 μV*ms [95% CI=15，260]，p=0.028）。探索性分析显示，性别对空腹NEFA（pinteraction=0.044）和负荷后血糖（pinteraction=0.015）与AF之间存在显著的相互作用，女性的相关性更强。对于负荷后血糖，在女性中观察到与AF事件的相关性，但在男性中未观察到。在老年人中，负荷后血糖与AF事件正相关，PTFV 1的研究结果一致。在探索性分析中，与AF的关系似乎仅限于女性。这些发现需要进一步的研究，但表明，干预措施，以解决餐后代谢紊乱的生活后期可能会减少AF。
Obesity and dysmetabolism are major risk factors for atrial fibrillation (AF). Fasting and post-load levels of glucose and non-esterified fatty acids (NEFA) reflect different facets of metabolic regulation. We sought to study their respective contributions to AF risk concurrently. We assessed levels of fasting and post-load glucose and NEFA in the Cardiovascular Health Study to identify associations with AF incidence, and secondarily with ECG parameters of AF risk available at baseline. Linear and Cox regressions were performed. The study included 1,876 participants (age 77.7±4.4). During median follow-up of 11.4 years, 717 cases of incident AF occurred. After adjustment for potential confounders, post-load glucose showed an association with incident AF (HR per SD increment of post-load glucose=1.11 [95% CI=1.02, 1.21], p=0.017). Both glucose measures, but not NEFA, were positively associated with higher P wave terminal force in V1 (PTFV1); the association remained significant only for post-load glucose when the two measures were entered together (β per SD increment=138 μV*ms [95% CI=15, 260], p=0.028). Exploratory analyses showed significant interaction by sex for fasting NEFA (pinteraction=0.044) and post-load glucose (pinteraction=0.015) relative to AF, with relationships stronger in women. For post-load glucose, the association with incident AF was observed among women, but not men. Among older adults, post-load glucose was positively associated with incident AF, with consistent findings for PTFV1. In exploratory analyses, the relationship with AF appeared specific to women. These findings require further study, but suggest that interventions to address post-prandial dysglycemia late in life might reduce AF.
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生命后期的单个非层化脂肪酸和入射房颤。
DOI：
10.1136/heartjnl-2020-317929
发表时间：
2021-11
期刊：
Heart (British Cardiac Society)
影响因子：
--
作者：
Pellegrini CN;Buzkova P;Lichtenstein AH;Matthan NR;Ix JH;Siscovick DS;Heckbert SR;Tracy RP;Mukamal KJ;Djoussé L;Kizer JR
通讯作者：
Kizer JR
影响因子：
5.5
作者：
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通讯作者：
Holst, Anders G.
影响因子：
5
作者：
Shitole, Sanyog G.;Biggs, Mary L.;Kizer, Jorge R.
通讯作者：
Kizer, Jorge R.
影响因子：
120.7
作者：
Menke, Andy;Casagrande, Sarah;Cowie, Catherine C.
通讯作者：
Cowie, Catherine C.
影响因子：
16.2
作者：
Kizer JR;Arnold AM;Benkeser D;Ix JH;Djousse L;Zieman SJ;Barzilay JI;Tracy RP;Mantzoros CS;Siscovick DS;Mukamal KJ
通讯作者：
Mukamal KJ