Type 2 diabetes, glucose homeostasis and incident atrial fibrillation: the Atherosclerosis risk in communities study

Huxley, Rachel R., Alonso, Alvaro, Lopez, Faye L., Filion, Kristian B., Agarwal, Sunil K., Loehr, Laura R., Soliman, Elsayed Z., Pankow, James S. and Selvin, Elizabeth (2012) Type 2 diabetes, glucose homeostasis and incident atrial fibrillation: the Atherosclerosis risk in communities study. Heart, 98 2: 133-138. doi:10.1136/heartjnl-2011-300503


Author Huxley, Rachel R.
Alonso, Alvaro
Lopez, Faye L.
Filion, Kristian B.
Agarwal, Sunil K.
Loehr, Laura R.
Soliman, Elsayed Z.
Pankow, James S.
Selvin, Elizabeth
Title Type 2 diabetes, glucose homeostasis and incident atrial fibrillation: the Atherosclerosis risk in communities study
Journal name Heart   Check publisher's open access policy
ISSN 1355-6037
1468-201X
Publication date 2012-01
Sub-type Article (original research)
DOI 10.1136/heartjnl-2011-300503
Volume 98
Issue 2
Start page 133
End page 138
Total pages 6
Place of publication London , United Kingdom
Publisher B M J Group
Language eng
Abstract Background: Type 2 diabetes has been inconsistently associated with the risk of atrial fibrillation (AF) in previous studies that have frequently been beset by methodological challenges. Design: Prospective cohort study. Setting: The Atherosclerosis Risk in Communities (ARIC) study. Participants: Detailed medical histories were obtained from 13 025 participants. Individuals were categorised as having no diabetes, pre-diabetes or diabetes based on the 2010 American Diabetes Association criteria at study baseline (1990-2). Main outcome measures: Diagnoses of incident AF were obtained to the end of 2007. Associations between type 2 diabetes and markers of glucose homeostasis and the incidence of AF were estimated using Cox proportional hazards models after adjusting for possible confounders. Results: Type 2 diabetes was associated with a significant increase in the risk of AF (HR 1.35, 95% CI 1.14 to 1.60) after adjustment for confounders. There was no indication that individuals with pre-diabetes or those with undiagnosed diabetes were at increased risk of AF compared with those without diabetes. A positive linear association was observed between HbA1c and the risk of AF in those with and without diabetes (HR 1.13, 95% CI 1.07 to 1.20) and HR 1.05, 95% CI 0.96 to 1.15 per 1% point increase, respectively). There was no association between fasting glucose or insulin in those without diabetes, but a significant association with fasting glucose was found in those with the condition. The results were similar in white subjects and African-Americans. Conclusions: Diabetes, HbA1c level and poor glycaemic control are independently associated with an increased risk of AF, but the underlying mechanisms governing the relationship are unknown and warrant further investigation.
Keyword Metabolic syndrome
Whites
Stroke
Adults
Men
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Public Health Publications
 
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