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Factors associated with atrial fibrillation in Japanese patients with type 2 diabetes mellitus: a cross-sectional study

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Abstract

Aims

Atrial fibrillation (AF) increases cardiovascular complications and mortality in patients with diabetes. Diabetes is a risk factor for AF; however, risk factors for AF among patients with type 2 diabetes (T2D) remain unknown, especially among Asian people. We clarified the prevalence of AF, regardless of type (i.e., paroxysmal, persistent, or permanent) in Japanese patients with T2D and clarified factors associated with AF.

Methods

This cross-sectional study was conducted at Fujiidera Municipal Hospital (Osaka, Japan). Patients with T2D (n = 899: 518 men and 381 women with a mean age ± SD of 69.0 ± 12.1 years) were included. Their electrocardiographs were checked during routine examinations between January 2017 and January 2018. A diagnosis of AF was determined from single time-point standard 12-lead electrocardiographic findings. We analyzed clinical parameters (e.g., age, sex, diabetes duration, glycated hemoglobin, body mass index, estimated glomerular filtration rate, albuminuria or proteinuria, use of biguanide, and presence of hypertension) between patients with and without AF.

Results

The prevalence of AF among patients with T2D was 5.9%; it became higher as age increased and tended to be higher in men than in women. The prevalence became higher as albuminuria or proteinuria progressed and as the eGFR decreased. Multiple logistic regression analyses revealed that older age, male sex, and reduced eGFR were independently and significantly associated with the coexistence of AF. However, multiple logistic regression analysis revealed no significant relationships between AF and the presence of albuminuria or proteinuria.

Conclusions

Older age, male sex, and reduced eGFR were associated with AF in Japanese patients with T2D.

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Authors and Affiliations

  1. Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan

    Natsuki Honda, Akinobu Ochi, Yoshinori Kakutani, Yuko Yamazaki, Tomoaki Morioka, Masaaki Inaba & Masanori Emoto

  2. Internal Medicine, Fujiidera Municipal Hospital, 2-7-3, Domyozi, Fujiidera City, Osaka, 583-0012, Japan

    Natsuki Honda & Sadahiko Uchimoto

  3. Department of Vascular Medicine, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan

    Tetsuo Shoji

  4. Vascular Science Center for Translational Research, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan

    Tetsuo Shoji

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  1. Natsuki Honda
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Contributions

NH primarily contributed to all parts of the study. AO contributed to the analyses, interpretation, and writing of the manuscript. SU contributed to the study conceptualization, study design, data collection, analyses, interpretation, and review of the manuscript. YK, YY, TM, and TS contributed to the interpretation and the review and editing of the manuscript. MI contributed to the study conceptualization and the review and editing of the manuscript. ME contributed to the study conceptualization, analyses interpretation, and review and writing of the manuscript.

Corresponding author

Correspondence to Akinobu Ochi.

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Conflict of interest

Natsuki Honda, Akinobu Ochi, Sadahiko Uchimoto, Yoshinori Kakutani, Yuko Yamazaki, Tomoaki Morioka, Masaaki Inaba and Masanori Emoto declare no conflicts of interests associated with this study. Tetsuo Shoji received an honorarium from Chugai Pharmaceutical Co., Ltd. (Tokyo, Japan) and Ono Pharmaceutical Co., Ltd. (Osaka, Japan), and received research funding from Ono Pharmaceutical Co. Ltd. and Bayer Yakuhin, Ltd. (Osaka City, Japan).

Human rights statement

All procedures were followed in accordance with the ethical standards of the responsible committee on human experimentation (the ethics committee of Fujiidera Municipal Hospital) and with the Helsinki Declaration of 1964 and later versions. T2D patients with AF have a higher risk of stroke. In the present study, we started anticoagulant therapy in AF patients who had not received anticoagulant therapy to prevent stroke, except for the patients with high risk of bleeding.

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Honda, N., Ochi, A., Uchimoto, S. et al. Factors associated with atrial fibrillation in Japanese patients with type 2 diabetes mellitus: a cross-sectional study. Diabetol Int 13, 503–512 (2022). https://doi.org/10.1007/s13340-021-00563-w

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