Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Provincial Engineering Research Center of Vascular Interventional Therapy, Wuhan, China.
Department of Dermatology, Wuhan No. 1 Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Diabetes Metab Syndr. 2024 Mar;18(3):102971. doi: 10.1016/j.dsx.2024.102971. Epub 2024 Mar 1.
The association of diabetes onset age and duration with incident arrhythmias remains unclear. This study evaluates the association of diabetes onset age and duration with incident arrhythmias and assesses modifications by the genetic predisposition to atrial fibrillation (AF).
We included 457,151 participants from the UK Biobank study. Multivariable Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) were used for the association between diabetes status, genetic predisposition, and risk of incident arrhythmias. The polygenic risk score (PRS) for AF comprised 142 single-nucleotide variants.
Over 12 years of follow-up, we documented 23,518 AF, 9079 bradyarrhythmia, 9280 conduction system diseases, 3358 supraventricular arrhythmias, and 3095 ventricular arrhythmias. Compared with non-diabetes, the risks of AF increased by 19%, 25%, and 36% for those with diabetes durations <5, 5-9, and ≥10 years, respectively. After multivariate adjustment, with the increase in diabetes onset age, the HRs of outcomes were gradually attenuated. The multivariable-adjusted HRs (95% CI) of diabetes for AF were 1.46 (1.24-1.71) in early middle age (<55 years), 1.21 (1.12-1.30) in late middle age (55-64 years), and 1.15 (1.06-1.24) in the elderly population (≥65 years). A significant interaction between diabetes status and AF-PRS for incident AF was observed (P for interaction <0.001). The same trends were observed for the other arrhythmias.
Diabetes was associated with higher risks of incident arrhythmias, and younger age at onset of diabetes was significantly associated with higher risk of subsequent arrhythmias.
糖尿病发病年龄和病程与心律失常事件的关系尚不清楚。本研究评估了糖尿病发病年龄和病程与心律失常事件的关系，并评估了心房颤动（AF）遗传易感性的修饰作用。
我们纳入了英国生物库研究中的 457151 名参与者。多变量 Cox 回归模型用于估计糖尿病状态、遗传易感性与心律失常事件发生风险之间的危险比（HR）和 95%置信区间（CI）。AF 的多基因风险评分（PRS）由 142 个单核苷酸变异组成。
在 12 年的随访期间，我们记录了 23518 例 AF、9079 例心动过缓、9280 例传导系统疾病、3358 例室上性心律失常和 3095 例室性心律失常。与非糖尿病患者相比，病程<5 年、5-9 年和≥10 年的患者发生 AF 的风险分别增加了 19%、25%和 36%。在多变量调整后，随着糖尿病发病年龄的增加，各结局的 HR 逐渐减弱。多变量调整后的 HR（95%CI）糖尿病发生 AF 的 HR 分别为 55 岁以下的早期中年为 1.46（1.24-1.71），55-64 岁的中老年为 1.21（1.12-1.30），≥65 岁的老年人群为 1.15（1.06-1.24）。糖尿病状态和 AF-PRS 与新发 AF 之间存在显著的交互作用（交互作用 P<0.001）。其他心律失常也观察到了相同的趋势。
糖尿病与心律失常事件的发生风险增加相关，糖尿病发病年龄越小，随后发生心律失常的风险越高。
