Southside Endocrinology and Diabetes and Thyroid Associates, Birmingham, Alabama.
Diabetes Obes Metab. 2019 Feb;21(2):210-217. doi: 10.1111/dom.13512. Epub 2018 Sep 25.
New-onset atrial fibrillation (NAF) is increased in the type 2 diabetic patient because of the presence of the metaboli syndrome and increased sympathetic activity. This results in inflammation, endothelial dysfunction and myocardial steatosis which, in turn, lead to atrial fibrosis and dilatation. The end result is the development of structural and electrical atrial remodeling. Drugs that lower insulin resistance, particularly pioglitazone, decrease the incidence of NAF while drugs that, through hypoglycaemia, stimulate the sympathetic nervous system, insulin and secretagogues, increase the incidence of NAF. Currently there is no evidence that GLP-1 agonists, SGLT2 inhibitors and DPP-4 inhibitors either accelerate or decelerate the development of NAF.
新发性心房颤动（NAF）在 2 型糖尿病患者中增加，因为代谢综合征和交感神经活动增加。这导致炎症、内皮功能障碍和心肌脂肪变性，进而导致心房纤维化和扩张。最终结果是结构和电心房重构的发展。降低胰岛素抵抗的药物，特别是吡格列酮，可降低 NAF 的发生率，而通过低血糖刺激交感神经系统、胰岛素和分泌素的药物则会增加 NAF 的发生率。目前尚无证据表明 GLP-1 激动剂、SGLT2 抑制剂和 DPP-4 抑制剂会加速或减缓 NAF 的发展。
