Meta-analysis of cohort and case-control studies of type 2 diabetes mellitus and risk of atrial fibrillation.
Meta-analysis of cohort and case-control studies of type 2 diabetes mellitus and risk of atrial fibrillation.
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DOI：
10.1016/j.amjcard.2011.03.004
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发表时间：
2011-07-01
影响因子：
2.8
通讯作者：
Alonso, Alvaro
中科院分区：
文献类型：
--
作者：
Huxley, Rachel R.;Filion, Kristian B.;Konety, Suma;Alonso, Alvaro
心房颤动（AF）是临床诊断最多的心脏疾病之一，但对其危险因素知之甚少。以往的流行病学研究报告了糖尿病（DM）与随后的AF风险之间的相关性，但结果不一致。本研究的目的是对已发表的研究进行荟萃分析，以可靠地确定DM和AF之间任何关联的方向和程度。检索PUBMED和EMBASE，以确定截至2010年4月报告了DM和其他血糖稳态指标与AF事件之间相关性的前瞻性队列和病例对照研究。排除了主要在高风险人群中进行的研究和随机对照试验的参与者。7项前瞻性队列研究和4项病例对照研究（包含1，686，097例患者中108，703例AF病例的信息）促成了这项分析。汇总估计表明，与未受影响的个体相比，DM个体的AF风险高出约40%：RR 1.39（95%置信区间：1.10 - 1.75;异质性p <0.001）。校正发表偏倚后，RR为XXXXXXX。与年龄调整研究相比，调整多个风险因素的研究报告了较小的效应估计值：RR 1.24（95%置信区间：1.06 - 1.44）vs 1.70（1.29 - 2.22）;异质性p = 0.053。DM所致AF的人群归因分数为2.5%（95% CI：0.1 - 3.9%）。总之，糖尿病与继发性房颤的风险增加有关，但可能支持糖尿病与房颤之间关系的机制仍然是推测性的。
Atrial fibrillation (AF) is one of the most clinically diagnosed cardiac disturbances but little is known about its risk factors. Previous epidemiological studies have reported on the association between diabetes mellitus (DM) and subsequent risk of AF with inconsistent results. The aim of this study was to conduct a meta-analysis of published studies to reliably determine the direction and magnitude of any association between DM and AF. A systematic review and meta-analysis was conducted. PUBMED and EMBASE were searched to identify prospective cohort and case-control studies that had reported on the association between DM and other measures of glucose homeostasis with incident AF by April 2010. Studies conducted in primarily high-risk populations and participants in randomized controlled trials were excluded. Seven prospective cohort studies and four case-control studies with information on 108,703 cases of AF among 1,686,097 individuals contributed to this analysis. The summary estimate indicated that individuals with DM had an approximate 40% greater risk of AF compared with unaffected individuals: RR 1.39 (95% Confidence Intervals: 1.10 – 1.75; p for heterogeneity <0.001). After correcting for publication bias the RR was XXXXXXX. Studies that had adjusted for multiple risk factors reported a smaller effect estimate compared with age-adjusted studies: RR 1.24 (95% Confidence Intervals: 1.06 – 1.44) versus 1.70 (1.29 – 2.22); p for heterogeneity = 0.053. The population attributable fraction of AF due to DM was 2.5% (95% CI: 0.1 – 3.9%). In conclusion, DM is associated with an increased risk of subsequent AF but the mechanisms that may underpin the relation between DM and AF remain speculative.
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影响因子：
39.3
作者：
Rosengren, Annika;Hauptman, Paul J.;Swedberg, Karl
通讯作者：
Swedberg, Karl
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