Insulin resistance and atrial fibrillation (from the Framingham Heart Study).

Fontes JD, Lyass A, Massaro JM, Rienstra M, Dallmeier D, Schnabel RB, Wang TJ, Vasan RS, Lubitz SA, Magnani JW, Levy D, Ellinor PT, Fox CS, Benjamin EJ
Am J Cardiol. 2012 109 (1): 87-90

PMID: 21996140 · PMCID: PMC3242834 · DOI:10.1016/j.amjcard.2011.08.008

Diabetes mellitus and obesity are increasing in prevalence and are associated with an elevated risk of atrial fibrillation (AF). Given the aging of the United States population, AF is projected to concomitantly increase in prevalence in the upcoming decades. Both diabetes and obesity are associated with insulin resistance. Whether insulin resistance is an intermediate step for the development of AF is uncertain. We hypothesized that insulin resistance is associated with an increased risk of incident AF. We examined the association of insulin resistance with incident AF using multivariate Cox proportional hazards regression analysis adjusting for the established AF risk factors (i.e., age, gender, systolic blood pressure, hypertension treatment, PR interval, significant heart murmur, heart failure, and body mass index). Of the 3,023 eligible participants (55% women; mean age 59 years) representing 4,583 person-examinations (Framingham Offspring fifth and seventh examination cycles), 279 participants developed AF (9.3%) within ≤10 years of follow-up. With multivariate modeling, insulin resistance was not significantly associated with incident AF (hazard ratio comparing top quartile to other 3 quartiles of homeostatic model assessment index 1.18, 95% confidence interval 0.84 to 1.65, p = 0.34). In a community-based cohort with ≤10 years of follow-up, no significant association was observed between insulin resistance and incident AF.

Copyright © 2012 Elsevier Inc. All rights reserved.

MeSH Terms (17)

Aged Atrial Fibrillation Blood Glucose Body Mass Index Confidence Intervals Female Follow-Up Studies Humans Incidence Insulin Insulin Resistance Male Massachusetts Metabolic Syndrome Proportional Hazards Models Retrospective Studies Risk Factors

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