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Association between non‐alcoholic fatty liver disease and risk of new‐onset atrial fibrillation in healthy adults
Author(s) -
Roh JaeHyung,
Lee JaeHwan,
Lee Hanbyul,
Yoon YongHoon,
Kim Minsu,
Kim YongGiun,
Park GyungMin,
Park JaeHyeong,
Seong InWhan
Publication year - 2020
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.14236
Subject(s) - medicine , atrial fibrillation , hazard ratio , fatty liver , confidence interval , quartile , proportional hazards model , incidence (geometry) , population , gastroenterology , cumulative incidence , cardiology , cohort , disease , physics , environmental health , optics
Background & Aims Previous studies demonstrated conflicting results regarding the association between non‐alcoholic fatty liver disease (NAFLD) and atrial fibrillation (AF). The statistical power was not sufficient because of modest sample sizes of these studies. We analysed a large population‐based cohort to evaluate the association between NAFLD and AF. Methods We evaluated 334 280 healthy individuals without comorbidities who underwent National Health check‐ups in South Korea from 2009 to 2014. NAFLD was defined by a surrogate marker, the fatty liver index (FLI). The association between FLI and AF incidence was analysed using multivariate Cox proportional hazards regression models. Results During a median follow‐up of 5.3 years, 1415 subjects (0.4%) were newly diagnosed with AF. Subjects were categorized into quartile groups according to FLI (range: Q1, 0‐4.9; Q2, 5.0‐12.5; Q3, 12.6‐31.0; Q4, >31.0). The cumulative incidence of AF was significantly higher in subjects with higher FLIs than in those with lower FLIs (Q1, 167 [0.2%]; Q2, 281 [0.3%]; Q3, 470 [0.6%]; Q4, 497 [0.6%]; P < .001). Adjusted hazard ratios (HRs) indicated that a higher FLI was independently associated with an increased risk for AF (HR between Q4 and Q1, 1.35; 95% confidence interval [CI], 1.11‐1.63; P = .002). After further adjustment for the interim events (diabetes, hypertension, heart failure and myocardial infarction), this association remained statistically significant (HR between Q4 and Q1, 1.55; 95% CI, 1.19‐2.03; P = .001). Conclusions NAFLD, assessed by FLI, was independently associated with increased risk for AF in healthy Korean population. Moreover, NAFLD itself predisposes to AF independently of the interim events.