A systematic review and meta-analysis of cohort studies on the potential association between NAFLD/MAFLD and risk of incident atrial fibrillation
Background and objectiveThe association between atrial fibrillation (AF) and non-alcoholic fatty liver disease (NAFLD) or metabolic-associated fatty liver disease (MAFLD) has been explored in recent cohort studies, however, the results have been controversial and inconclusive. This meta-analysis aim...
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Frontiers Media S.A.
2023-07-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1160532/full |
| _version_ | 1797786729246097408 |
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| author | Ben‐Gang Zhou Ben‐Gang Zhou Sheng-Yong Ju Yu-Zhou Mei Xin Jiang Meng Wang Ai-Jing Zheng Yan-Bing Ding Yan-Bing Ding |
| author_facet | Ben‐Gang Zhou Ben‐Gang Zhou Sheng-Yong Ju Yu-Zhou Mei Xin Jiang Meng Wang Ai-Jing Zheng Yan-Bing Ding Yan-Bing Ding |
| author_sort | Ben‐Gang Zhou |
| collection | DOAJ |
| description | Background and objectiveThe association between atrial fibrillation (AF) and non-alcoholic fatty liver disease (NAFLD) or metabolic-associated fatty liver disease (MAFLD) has been explored in recent cohort studies, however, the results have been controversial and inconclusive. This meta-analysis aimed to explore this potential association.MethodsWe systematically searched PubMed, Embase, and Web of Science databases to identify all relevant cohort studies investigating the association between NAFLD/MAFLD and AF published from database inception to October 30, 2022. Random-effects models were utilized to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for summary purposes. Additionally, subgroup and sensitivity analyses were performed.ResultsA total of 13 cohort studies with 14 272 735 participants were included. Among these, 12 cohort studies with 14 213 289 participants (median follow-up of 7.8 years) showed a significant association between NAFLD and an increased risk of incident AF (HR = 1.18, 95% CI: 1.12-1.23, P < 0.00001). Our subgroup analyses mostly yielded similar results, and the results of sensitivity analyses remained unchanged. However, meta-analysis of data from 2 cohort studies with 59 896 participants (median follow-up of 2.15 years) showed that MAFLD was not linked to incident AF (HR = 1.36, 95% CI: 0.63-2.92, P = 0.44).ConclusionCurrent evidence shows that NAFLD may be linked to a slightly higher risk of developing AF, particularly among Asian populations and those diagnosed with NAFLD using FLI criteria. Nevertheless, there is not enough evidence to support the proposed association between MAFLD and an increased risk of AF. To better understand this relationship, future studies should consider factors such as specific population, the severity of NAFLD/MAFLD, diagnostic methods of NAFLD and AF, and cardiometabolic risk factors.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero, identifier CRD42022371503. |
| first_indexed | 2024-03-13T01:12:02Z |
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| id | doaj.art-b9b0b5d922d844c29de3bb4b667691a4 |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-03-13T01:12:02Z |
| publishDate | 2023-07-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Endocrinology |
| spelling | doaj.art-b9b0b5d922d844c29de3bb4b667691a42023-07-05T17:43:08ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922023-07-011410.3389/fendo.2023.11605321160532A systematic review and meta-analysis of cohort studies on the potential association between NAFLD/MAFLD and risk of incident atrial fibrillationBen‐Gang Zhou0Ben‐Gang Zhou1Sheng-Yong Ju2Yu-Zhou Mei3Xin Jiang4Meng Wang5Ai-Jing Zheng6Yan-Bing Ding7Yan-Bing Ding8Dalian Medical University, Dalian, Liaoning, ChinaDepartment of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu, ChinaMedical Department, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu, ChinaDepartment of Gastroenterology, The People’s Hospital of China Three Gorges University, Yichang, Hubei, ChinaDepartment of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu, ChinaDepartment of Neurology, The Third Clinical Medical College of China, Three Gorges University, Gezhouba Central Hospital of Sinopharm, Yichang, Hubei, ChinaDepartment of Gastroenterology, The People’s Hospital of China Three Gorges University, Yichang, Hubei, ChinaDalian Medical University, Dalian, Liaoning, ChinaDepartment of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu, ChinaBackground and objectiveThe association between atrial fibrillation (AF) and non-alcoholic fatty liver disease (NAFLD) or metabolic-associated fatty liver disease (MAFLD) has been explored in recent cohort studies, however, the results have been controversial and inconclusive. This meta-analysis aimed to explore this potential association.MethodsWe systematically searched PubMed, Embase, and Web of Science databases to identify all relevant cohort studies investigating the association between NAFLD/MAFLD and AF published from database inception to October 30, 2022. Random-effects models were utilized to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for summary purposes. Additionally, subgroup and sensitivity analyses were performed.ResultsA total of 13 cohort studies with 14 272 735 participants were included. Among these, 12 cohort studies with 14 213 289 participants (median follow-up of 7.8 years) showed a significant association between NAFLD and an increased risk of incident AF (HR = 1.18, 95% CI: 1.12-1.23, P < 0.00001). Our subgroup analyses mostly yielded similar results, and the results of sensitivity analyses remained unchanged. However, meta-analysis of data from 2 cohort studies with 59 896 participants (median follow-up of 2.15 years) showed that MAFLD was not linked to incident AF (HR = 1.36, 95% CI: 0.63-2.92, P = 0.44).ConclusionCurrent evidence shows that NAFLD may be linked to a slightly higher risk of developing AF, particularly among Asian populations and those diagnosed with NAFLD using FLI criteria. Nevertheless, there is not enough evidence to support the proposed association between MAFLD and an increased risk of AF. To better understand this relationship, future studies should consider factors such as specific population, the severity of NAFLD/MAFLD, diagnostic methods of NAFLD and AF, and cardiometabolic risk factors.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero, identifier CRD42022371503.https://www.frontiersin.org/articles/10.3389/fendo.2023.1160532/fullmetabolic dysfunction-associated fatty liver diseaseatrial fibrillationsystematic reviewmeta-analysiscohort studiesnon-alcoholic fatty liver disease |
| spellingShingle | Ben‐Gang Zhou Ben‐Gang Zhou Sheng-Yong Ju Yu-Zhou Mei Xin Jiang Meng Wang Ai-Jing Zheng Yan-Bing Ding Yan-Bing Ding A systematic review and meta-analysis of cohort studies on the potential association between NAFLD/MAFLD and risk of incident atrial fibrillation Frontiers in Endocrinology metabolic dysfunction-associated fatty liver disease atrial fibrillation systematic review meta-analysis cohort studies non-alcoholic fatty liver disease |
| title | A systematic review and meta-analysis of cohort studies on the potential association between NAFLD/MAFLD and risk of incident atrial fibrillation |
| title_full | A systematic review and meta-analysis of cohort studies on the potential association between NAFLD/MAFLD and risk of incident atrial fibrillation |
| title_fullStr | A systematic review and meta-analysis of cohort studies on the potential association between NAFLD/MAFLD and risk of incident atrial fibrillation |
| title_full_unstemmed | A systematic review and meta-analysis of cohort studies on the potential association between NAFLD/MAFLD and risk of incident atrial fibrillation |
| title_short | A systematic review and meta-analysis of cohort studies on the potential association between NAFLD/MAFLD and risk of incident atrial fibrillation |
| title_sort | systematic review and meta analysis of cohort studies on the potential association between nafld mafld and risk of incident atrial fibrillation |
| topic | metabolic dysfunction-associated fatty liver disease atrial fibrillation systematic review meta-analysis cohort studies non-alcoholic fatty liver disease |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1160532/full |
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