Serum albumin and atrial fibrillation: insights from epidemiological and mendelian randomization studies
Serum albumin and atrial fibrillation: insights from epidemiological and mendelian randomization studies
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血清白蛋白和心房颤动：流行病学和孟德尔随机研究的见解
DOI：
10.1007/s10654-019-00583-6
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发表时间：
2020-02-01
影响因子：
13.6
通讯作者：
Liao, Xin-xue
中科院分区：
文献类型：
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作者：
Liao, Li-zhen;Zhang, Shao-zhao;Liao, Xin-xue
心房颤动（AF）是临床实践中最常见的心律失常。低血清白蛋白水平与许多心血管疾病（包括房颤）的出现有关。在这项研究中，我们旨在描述社区动脉粥样硬化风险 (ARIC) 研究中血清白蛋白与 AF 事件之间前瞻性关联的性质和程度，并调查它们之间关联的任何因果关系。 ARIC 研究是一项针对美国四个社区心血管危险因素的基于人群的前瞻性队列研究，最初由 1987 年至 1989 年间招募的 15,792 名年龄 45-64 岁的参与者组成（访问 1）。本研究的最终样本量为 12,833。酌情使用单向方差分析、卡方检验或 Kruskal-Wallis 检验来比较各组之间的基线（访视 1）特征。我们使用多变量 Cox 风险回归模型来评估白蛋白与 AF 事件之间的关联。基于全基因组关联研究公开的汇总级数据的两样本孟德尔随机化 (MR) 用于估计血清白蛋白和事件 AF 的因果影响。在中位随访 25.1 年期间，2259 名参与者 (17.6%) 发生了房颤。经过多重调整后，血清白蛋白与 AF 发生率呈负相关 [HR = 0.90，95% CI 0.86–0.94，每增加一个 SD (0.27 g/dL)； HR = 0.80，95% CI 0.71–0.91，Q4 与 Q1]。在 MR 分析中，我们在反方差加权 (IVW) 方法中没有检测到血清白蛋白水平与 AF 之间存在因果关系的证据（比值比：0.996，95% CI 0.980–1.012，白蛋白每增加 1 g/dL；P= 0.620），没有证据表明各个 SNP 估计值之间存在异质性（光均性= 0.981 [MR-Egger]和光均性= 0.860 [IVW]）也没有多效性效应（多效性= 0.193）。血清白蛋白水平与 AF 事件呈线性负相关。然而，MR 分析并不支持血清白蛋白在 AF 病因学中的因果作用。
Atrial fibrillation (AF) is the most common arrhythmia in clinical practice. Low serum albumin level is linked to the emergence of many cardiovascular diseases, including AF. In this study, we aim to characterize the nature and magnitude of the prospective association between serum albumin and incident AF in the Atherosclerosis Risk in Communities (ARIC) Study and investigate any causal relevance to the association between them. ARIC Study is a population-based, prospective, cohort study of cardiovascular risk factors in four US communities, initially consisting of 15,792 participants, aged 45–64 years, recruited between 1987 and 1989 (visit 1). The final sample size was 12,833 in this study. Baseline (visit 1) characteristics were compared between groups using one-way ANOVA test, Chi square test, or Kruskal–Wallis test as appropriate. We used multivariable Cox’ hazard regression models to assess the association between albumin and incident AF. Two-sample Mendelian randomization (MR) based on publicly available summary-level data from genome-wide association studies was used to estimate the causal influence of the serum albumin and incident AF. During a median follow-up of 25.1 years, 2259 (17.6%) participants developed incident AF. After multiple adjustment, serum albumin was inversely associated with incidence of AF [HR = 0.90, 95% CI 0.86–0.94, per SD (0.27 g/dL) increase; HR = 0.80, 95% CI 0.71–0.91, Q4 vs. Q1]. In MR analysis, we detected no evidence for a causal relation between serum albumin level and AF in inverse-variance weighted (IVW) method (odds ratio: 0.996, 95% CI 0.980–1.012, per 1 g/dL increase of albumin;P= 0.620) without evidence of heterogeneity between estimates from individual SNPs (Pheterogeneity= 0.981 [MR-Egger] andPheterogeneity= 0.860 [IVW]) nor pleiotropy effect (Ppleiotropy= 0.193). The serum albumin level is independently inverse associated with incident AF in a linear pattern. However, MR analyses did not support a causal role of serum albumin in the etiology of AF.