Lee Ming-Chuan, Wang Yu-Tsang, Li Yu-Ju, Tsai Ching-Yi, Chen Su-Te, Jhuang Wun-Jyun, Chang Meng-Chi, Chien Mei-Yu, Lee Hsiang-Chun
Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 807, Taiwan.
Division of Medical Statistics and Bioinformatics, Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 807, Taiwan.
Int J Gen Med. 2022 Jul 15;15:6189-6198. doi: 10.2147/IJGM.S361705. eCollection 2022.
Manifestations of metabolic syndrome (MetS) carry risks for atrial fibrillation (AF). The study determined whether any electrocardiographic parameter can reflect increased AF risk in individuals with MetS.
From our University Hospital database, we examined the presence of AF and its correlation with MetS manifestations, renal function, lipid profiles, and electrocardiographic parameters (P wave duration, PR interval, QRS width, and QTc intervals). Between January 2008 and December 2015, data from 4479 adults (women 41.6% vs men 58.4%) were identified.
The overall prevalence of AF was 12.4%, without sex differences (women, 12.8% vs men, 12.1%). Patients with AF were older (age 73.9 ± 11.8 vs non-AF 67 ± 13.5 years), with lower lipid levels (TG, total cholesterol, and LDL-cholesterol, all p < 0.0001), and at lower eGFR level (64.1 ± 30.9 vs non-AF 68.8 ± 41.4 mL/min/1.73m2, p < 0.0001). Besides, sex differences were present in all electrocardiographic parameters (all p < 0.05). Hypertension had the highest odds ratio (1.33; p = 0.026) for AF. Comparing AF to non-AF, the QTc of quartiles was significantly different (p < 0.0089). The shortest and longest QTc quartiles had an increased incidence of AF.
AF risk in patients with MetS phenotypes can be reflected by QTc quartiles.
代谢综合征（MetS）的表现会增加心房颤动（AF）的风险。本研究旨在确定是否有任何心电图参数能够反映MetS患者发生AF风险的增加。
从我们大学医院的数据库中，我们检查了AF的存在情况及其与MetS表现、肾功能、血脂谱和心电图参数（P波时限、PR间期、QRS波宽度和QTc间期）的相关性。2008年1月至2015年12月期间，共纳入4479名成年人的数据（女性占41.6%，男性占58.4%）。
AF的总体患病率为12.4%，无性别差异（女性为12.8%，男性为12.1%）。AF患者年龄较大（73.9±11.8岁，非AF患者为67±13.5岁），血脂水平较低（甘油三酯、总胆固醇和低密度脂蛋白胆固醇，均p<0.0001），估算肾小球滤过率（eGFR）水平较低（64.1±30.9 vs非AF患者68.8±41.4 mL/min/1.73m2，p<0.0001）。此外，所有心电图参数均存在性别差异（均p<0.05）。高血压患者发生AF的比值比最高（1.33；p=0.026）。将AF患者与非AF患者进行比较，QTc四分位数有显著差异（p<0.0089）。最短和最长QTc四分位数组的AF发生率增加。
MetS表型患者的AF风险可通过QTc四分位数反映。
