Li Xiaozhong, Zhou Zheng, Xia Zhen, Dong Youzheng, Chen Si, Zhan Fenfang, Wang Zhichao, Chen Yang, Yu Jianhua, Xia Zirong, Li Juxiang
Department of Cardiovascular Medicine, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China.
Department of Anesthesiology, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China.
Eur J Med Res. 2024 Jun 12;29(1):325. doi: 10.1186/s40001-024-01911-7.
Previous studies have shown a clear link between insulin resistance (IR) and an elevated risk of atrial fibrillation (AF). However, the relationship between the estimated glucose disposal rate (eGDR), which serves as a marker for IR, and the risk of AF recurrence after radiofrequency catheter ablation (RFCA) remains uncertain. Therefore, this study aimed to examine the potential association between the eGDR and the risk of AF recurrence following RFCA.
This retrospective study was conducted at Nanchang University Affiliated Second Hospital. The study enrolled 899 patients with AF who underwent RFCA between January 2015 and January 2022. The formula used to calculate the eGDR was as follows: 19.02 - (0.22 * body mass index) - (3.26 * hypertension) - (0.61 * HbA1c). Cox proportional hazard regression models and exposure-effect curves were used to explore the correlation between the baseline eGDR and AF recurrence. The ability of the eGDR to predict AF recurrence was evaluated using the area under the receiver operating characteristic curve (AUROC).
The study observed a median follow-up period of 11.63 months, during which 296 patients experienced AF recurrence. K‒M analyses revealed that the cumulative incidence AF recurrence rate was significantly greater in the group with the lowest eGDR (log-rank p < 0.01). Participants with an eGDR ≥ 8 mg/kg/min had a lower risk of AF recurrence than those with an eGDR < 4 mg/kg/min, with a hazard ratio (HR) of 0.28 [95% confidence interval (CI) 0.18, 0.42]. Additionally, restricted cubic spline analyses demonstrated a linear association between the eGDR and AF recurrence (p nonlinear = 0.70). The area under the curve (AUC) for predicting AF recurrence using the eGDR was 0.75.
The study revealed that a decrease in the eGDR is associated with a greater AF recurrence risk after RFCA. Hence, the eGDR could be used as a novel biomarker for assessing AF recurrence risk.
既往研究表明胰岛素抵抗（IR）与房颤（AF）风险升高之间存在明确关联。然而，作为IR标志物的估计葡萄糖处置率（eGDR）与射频导管消融（RFCA）术后房颤复发风险之间的关系仍不明确。因此，本研究旨在探讨eGDR与RFCA术后房颤复发风险之间的潜在关联。
本回顾性研究在南昌大学第二附属医院进行。该研究纳入了2015年1月至2022年1月期间接受RFCA的899例房颤患者。计算eGDR的公式如下：19.02 - （0.22×体重指数） - （3.26×高血压） - （0.61×糖化血红蛋白）。采用Cox比例风险回归模型和暴露 - 效应曲线来探讨基线eGDR与房颤复发之间的相关性。使用受试者工作特征曲线下面积（AUROC）评估eGDR预测房颤复发的能力。
该研究观察到的中位随访期为11.63个月，在此期间296例患者发生房颤复发。K - M分析显示，eGDR最低组的房颤复发累积发生率显著更高（对数秩检验p < 0.01）。eGDR≥8 mg/kg/min的参与者房颤复发风险低于eGDR < 4 mg/kg/min的参与者，风险比（HR）为0.28 [95%置信区间（CI）0.18, 0.42]。此外，限制性立方样条分析显示eGDR与房颤复发之间存在线性关联（p非线性 = 0.70）。使用eGDR预测房颤复发的曲线下面积（AUC）为0.75。
该研究表明，eGDR降低与RFCA术后更高的房颤复发风险相关。因此，eGDR可作为评估房颤复发风险的一种新型生物标志物。
