Serum glycated hemoglobin level as a predictor of atrial fibrillation: A systematic review with meta-analysis and meta-regression.
BACKGROUND AND AIM:Glycated hemoglobin (HbA1c) is a long-term measure of glucose control. Although recent studies demonstrated a potential association between HbA1c levels and the risk of atrial fibrillation (AF), the results have been inconsistent. The aim of this meta-analysis is to evaluate the u...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2017-01-01
|
| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC5340354?pdf=render |
| _version_ | 1818310588482191360 |
|---|---|
| author | Wenwei Qi Nixiao Zhang Panagiotis Korantzopoulos Konstantinos P Letsas Min Cheng Fusheng Di Gary Tse Tong Liu Guangping Li |
| author_facet | Wenwei Qi Nixiao Zhang Panagiotis Korantzopoulos Konstantinos P Letsas Min Cheng Fusheng Di Gary Tse Tong Liu Guangping Li |
| author_sort | Wenwei Qi |
| collection | DOAJ |
| description | BACKGROUND AND AIM:Glycated hemoglobin (HbA1c) is a long-term measure of glucose control. Although recent studies demonstrated a potential association between HbA1c levels and the risk of atrial fibrillation (AF), the results have been inconsistent. The aim of this meta-analysis is to evaluate the utility of HbA1c level in predicting AF. METHODS:PubMed and the Cochrane Library databases were searched for relevant studies up to March 2016. Prospective cohort studies and retrospective case-control studies were included. Relative risk (RR) or odds ratio (OR) with 95% confidence intervals (CIs) of AF development were determined for different HbA1c levels. The random effect model was conducted according to the test of heterogeneity among studies. Subgroup analyses and meta-regression models were carried out to identify potential sources of heterogeneity. RESULTS:Eight prospective cohort studies with 102,006 participants and 6 retrospective case-control studies with 57,669 patients were finally included in the meta-analysis. In the primary meta-analysis, HbA1c levels were not associated with an increased risk of AF whether as a continuous (RR, 1.06; 95% CI, 0.96-1.18) or categorical variable (RR, 0.99; 95% CI, 0.83-1.18). Nevertheless, prospective studies showed about 10% increased risk of AF with elevated HbA1c levels both as a continuous (RR, 1.11; 95% CI, 1.06-1.16) and as a categorical variable (RR, 1.09; 95% CI, 1.00-1.18). In subgroup analyses, pooled results from studies with longer follow-up durations, published after 2012, aged < 63 years, with exclusion of cardiac surgery patients demonstrated an increased risk of AF for every 1% increase in HbA1c levels, while studies conducted in the United States with longer follow-up (more than 96 months), larger sample size and higher quality score (≥6) showed an increased risk of AF for higher HbA1c level as a categorical variable. CONCLUSIONS:Elevated serum HbA1c levels may be associated with an increased risk of AF, but further data are needed. Serum HbA1c levels might be considered as a potential biomarker for prediction of AF. |
| first_indexed | 2024-12-13T07:48:27Z |
| format | Article |
| id | doaj.art-403716e8dd74497fa10821904366ace3 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-13T07:48:27Z |
| publishDate | 2017-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-403716e8dd74497fa10821904366ace32022-12-21T23:54:45ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01123e017095510.1371/journal.pone.0170955Serum glycated hemoglobin level as a predictor of atrial fibrillation: A systematic review with meta-analysis and meta-regression.Wenwei QiNixiao ZhangPanagiotis KorantzopoulosKonstantinos P LetsasMin ChengFusheng DiGary TseTong LiuGuangping LiBACKGROUND AND AIM:Glycated hemoglobin (HbA1c) is a long-term measure of glucose control. Although recent studies demonstrated a potential association between HbA1c levels and the risk of atrial fibrillation (AF), the results have been inconsistent. The aim of this meta-analysis is to evaluate the utility of HbA1c level in predicting AF. METHODS:PubMed and the Cochrane Library databases were searched for relevant studies up to March 2016. Prospective cohort studies and retrospective case-control studies were included. Relative risk (RR) or odds ratio (OR) with 95% confidence intervals (CIs) of AF development were determined for different HbA1c levels. The random effect model was conducted according to the test of heterogeneity among studies. Subgroup analyses and meta-regression models were carried out to identify potential sources of heterogeneity. RESULTS:Eight prospective cohort studies with 102,006 participants and 6 retrospective case-control studies with 57,669 patients were finally included in the meta-analysis. In the primary meta-analysis, HbA1c levels were not associated with an increased risk of AF whether as a continuous (RR, 1.06; 95% CI, 0.96-1.18) or categorical variable (RR, 0.99; 95% CI, 0.83-1.18). Nevertheless, prospective studies showed about 10% increased risk of AF with elevated HbA1c levels both as a continuous (RR, 1.11; 95% CI, 1.06-1.16) and as a categorical variable (RR, 1.09; 95% CI, 1.00-1.18). In subgroup analyses, pooled results from studies with longer follow-up durations, published after 2012, aged < 63 years, with exclusion of cardiac surgery patients demonstrated an increased risk of AF for every 1% increase in HbA1c levels, while studies conducted in the United States with longer follow-up (more than 96 months), larger sample size and higher quality score (≥6) showed an increased risk of AF for higher HbA1c level as a categorical variable. CONCLUSIONS:Elevated serum HbA1c levels may be associated with an increased risk of AF, but further data are needed. Serum HbA1c levels might be considered as a potential biomarker for prediction of AF.http://europepmc.org/articles/PMC5340354?pdf=render |
| spellingShingle | Wenwei Qi Nixiao Zhang Panagiotis Korantzopoulos Konstantinos P Letsas Min Cheng Fusheng Di Gary Tse Tong Liu Guangping Li Serum glycated hemoglobin level as a predictor of atrial fibrillation: A systematic review with meta-analysis and meta-regression. PLoS ONE |
| title | Serum glycated hemoglobin level as a predictor of atrial fibrillation: A systematic review with meta-analysis and meta-regression. |
| title_full | Serum glycated hemoglobin level as a predictor of atrial fibrillation: A systematic review with meta-analysis and meta-regression. |
| title_fullStr | Serum glycated hemoglobin level as a predictor of atrial fibrillation: A systematic review with meta-analysis and meta-regression. |
| title_full_unstemmed | Serum glycated hemoglobin level as a predictor of atrial fibrillation: A systematic review with meta-analysis and meta-regression. |
| title_short | Serum glycated hemoglobin level as a predictor of atrial fibrillation: A systematic review with meta-analysis and meta-regression. |
| title_sort | serum glycated hemoglobin level as a predictor of atrial fibrillation a systematic review with meta analysis and meta regression |
| url | http://europepmc.org/articles/PMC5340354?pdf=render |
| work_keys_str_mv | AT wenweiqi serumglycatedhemoglobinlevelasapredictorofatrialfibrillationasystematicreviewwithmetaanalysisandmetaregression AT nixiaozhang serumglycatedhemoglobinlevelasapredictorofatrialfibrillationasystematicreviewwithmetaanalysisandmetaregression AT panagiotiskorantzopoulos serumglycatedhemoglobinlevelasapredictorofatrialfibrillationasystematicreviewwithmetaanalysisandmetaregression AT konstantinospletsas serumglycatedhemoglobinlevelasapredictorofatrialfibrillationasystematicreviewwithmetaanalysisandmetaregression AT mincheng serumglycatedhemoglobinlevelasapredictorofatrialfibrillationasystematicreviewwithmetaanalysisandmetaregression AT fushengdi serumglycatedhemoglobinlevelasapredictorofatrialfibrillationasystematicreviewwithmetaanalysisandmetaregression AT garytse serumglycatedhemoglobinlevelasapredictorofatrialfibrillationasystematicreviewwithmetaanalysisandmetaregression AT tongliu serumglycatedhemoglobinlevelasapredictorofatrialfibrillationasystematicreviewwithmetaanalysisandmetaregression AT guangpingli serumglycatedhemoglobinlevelasapredictorofatrialfibrillationasystematicreviewwithmetaanalysisandmetaregression |