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日本2型糖尿病患者心房颤动的相关因素:一项横断面研究。

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

作者信息

Honda Natsuki, Ochi Akinobu, Uchimoto Sadahiko, Kakutani Yoshinori, Yamazaki Yuko, Morioka Tomoaki, Shoji Tetsuo, Inaba Masaaki, Emoto Masanori

机构信息

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.

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

出版信息

Diabetol Int. 2022 Jan 24;13(3):503-512. doi: 10.1007/s13340-021-00563-w. eCollection 2022 Jul.

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 ( = 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.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s13340-021-00563-w.

摘要

目的

心房颤动(AF)会增加糖尿病患者的心血管并发症及死亡率。糖尿病是AF的一个危险因素;然而,2型糖尿病(T2D)患者中AF的危险因素仍不清楚,尤其是在亚洲人群中。我们明确了日本T2D患者中AF的患病率(无论其类型,即阵发性、持续性或永久性),并明确了与AF相关的因素。

方法

这项横断面研究在藤井寺市立医院(日本大阪)进行。纳入了T2D患者(n = 899:518名男性和381名女性,平均年龄±标准差为69.0±12.1岁)。在2017年1月至2018年1月的常规检查期间检查了他们的心电图。根据单次时间点的标准12导联心电图结果确定AF诊断。我们分析了有AF和无AF患者之间的临床参数(如年龄、性别、糖尿病病程、糖化血红蛋白、体重指数、估计肾小球滤过率、白蛋白尿或蛋白尿、双胍类药物的使用以及高血压的存在情况)。

结果

T2D患者中AF的患病率为5.9%;其患病率随年龄增长而升高,男性患病率往往高于女性。随着白蛋白尿或蛋白尿病情进展以及估算肾小球滤过率(eGFR)降低,患病率升高。多因素logistic回归分析显示,年龄较大、男性以及eGFR降低与AF并存独立且显著相关。然而,多因素logistic回归分析显示AF与白蛋白尿或蛋白尿的存在之间无显著关系。

结论

年龄较大、男性以及eGFR降低与日本T2D患者的AF相关。

补充信息

在线版本包含可在10.1007/s13340-021-00563-w获取的补充材料。

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