Diabetes and prediabetes not independent risk factors for AF

Previous research have reported an increased risk for atrial fibrillation and atrial flutter in patients with prediabetes and type 2 diabetes. However, there is no clarity on whether this increase in AF risk is independent of other risk factors for AF. Cecilia Johansson, Department of public health and clinical medicine, Umeå University, Sweden, and colleagues aimed to investigate the association between diabetes and different prediabetic states as independent risk factors for the onset of AF.

For this purpose, the researchers performed a population-based cohort study in Northern Sweden, comprising data on oral glucose tolerance tests, fasting plasma glucose, medical history, major cardiovascular risk factors, and lifestyle factors. Participants were divided into six groups based on glycemic status and followed through national registers to diagnose atrial fibrillation and atrial flutter. The association between glycemic status and AF was assessed using Cox proportional hazard model, and normoglycemia was the reference.

The study led to the following findings:

• The cohort consisted of 88,889 participants who underwent 139,661 health examinations.
• In the model adjusted for age and sex, there was a significant association between glycemic status and development of AF in all groups except the IGT group, with the strongest association for the group with known diabetes.
• In a model adjusted for sex, age, BMI, systolic blood pressure, antihypertensive drugs, alcohol, cholesterol, smoking, marital status, education level, and physical activity, there was no significant association between glycemic status and AF.

"The association between blood sugar status and atrial fibrillation disappears upon adjustment for potential confounders," the researchers wrote. "Prediabetes and diabetes do not appear to be independent risk factors for AF."

Reference:

Johansson, C., Örtendahl, L., Lind, M. M., Andersson, J., Johansson, L., & Brunström, M. Diabetes, prediabetes and atrial fibrillation – A population-based cohort study based on national and regional registers. Journal of Internal Medicine. https://doi.org/10.1111/joim.13688