脂联素与心房颤动的相关性：系统评价和荟萃分析。

Associations between adipokines and atrial fibrillation: A systematic review and meta-analysis.

机构信息

Adelaide Medical School, The University of Adelaide, Adelaide, Australia.

出版信息

Nutr Metab Cardiovasc Dis. 2022 Apr;32(4):853-862. doi: 10.1016/j.numecd.2022.01.019. Epub 2022 Jan 23.

DOI:10.1016/j.numecd.2022.01.019

PMID:35227548

Abstract

AIMS

Although overweight and obesity are associated with increased risk of atrial fibrillation (AF), the underlying mechanisms are not well characterised. Recent data suggest that this link may be partly due to abnormal adipose tissue-derived cytokines or adipokines. However, this relationship is not well clarified. To evaluate the association between adipokines and AF in a systematic review and meta-analysis.

DATA SYNTHESIS

PubMed, Embase, and Web of Science Core Collection were searched from inception through 1 March 2021. Studies were included if they reported any adipokine and AF, with their quality assessed using the Newcastle-Ottawa scale. Data were independently abstracted, with unadjusted and multivariable adjusted estimates pooled in a random-effects meta-analysis. Data are presented for overall prevalent or incident AF and AF subtypes (paroxysmal, persistent, or non-paroxysmal AF). A total of 34 studies, with 31,479 patients, were included. The following adipokines were significantly associated with AF in the pooled univariate data - apelin (risk ratio for prevalent AF: 0.05 [0.00-0.50], p = 0.01; recurrent AF: 0.21 [0.11-0.42], p < 0.01) and resistin (incident AF: 2.05 [1.02-4.1], p = 0.04; prevalent AF: 2.62 [1.78-3.85], p < 0.01). Pooled analysis of multivariable adjusted effect size estimates showed adiponectin as the sole independent predictor of AF incidence (1.14 [1.02-1.27], p = 0.02). Moreover, adiponectin was associated with non-paroxysmal AF (persistent AF: 1.45 [1.08-1.94, p = 0.01; non-paroxysmal versus paroxysmal AF: 3.14 [1.87-5.27, p < 0.01).

CONCLUSIONS

Adipokines, principally adiponectin, apelin, and resistin, are associated with the risk of atrial fibrillation. However, the association is not seen after multivariate adjustment, likely reflecting the lack of statistical power. Future research should investigate these relationships in larger prospective cohorts and how they can refine AF monitoring strategies.

PROSPERO ID

CRD42020208879.

摘要

目的

尽管超重和肥胖与心房颤动（AF）风险增加有关，但潜在机制尚不清楚。最近的数据表明，这种联系可能部分归因于异常脂肪组织衍生的细胞因子或脂肪因子。然而，这种关系尚未得到充分阐明。本系统评价和荟萃分析旨在评估脂肪因子与 AF 之间的关系。

数据合成

从成立到 2021 年 3 月 1 日，我们在 PubMed、Embase 和 Web of Science 核心合集上进行了搜索。如果研究报告了任何脂肪因子和 AF，并使用纽卡斯尔-渥太华量表评估其质量，则将其纳入研究。数据由独立人员提取，使用随机效应荟萃分析对未调整和多变量调整的估计值进行汇总。数据显示总体上的阵发性、持续性或非阵发性 AF 患者的现有或新发 AF 情况。共纳入 34 项研究，共 31479 例患者。在汇总的单变量数据中，以下脂肪因子与 AF 显著相关 - 脂联素（现患 AF 的风险比：0.05 [0.00-0.50]，p=0.01；复发性 AF：0.21 [0.11-0.42]，p<0.01）和抵抗素（新发 AF：2.05 [1.02-4.1]，p=0.04；现患 AF：2.62 [1.78-3.85]，p<0.01）。多变量调整效应大小估计值的汇总分析显示，脂联素是 AF 发病的唯一独立预测因子（1.14 [1.02-1.27]，p=0.02）。此外，脂联素与非阵发性 AF 相关（持续性 AF：1.45 [1.08-1.94]，p=0.01；非阵发性与阵发性 AF：3.14 [1.87-5.27]，p<0.01）。