Liang Hao, Zhang Shuai, Zhu Ye
Department of Cardiology, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, 225001, China.
Department of Gastroenterology, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, 225001, China.
BMC Cardiovasc Disord. 2025 Jan 27;25(1):51. doi: 10.1186/s12872-025-04508-y.
The aim of this study was to explore the correlation between blood test indicators and Atrial Fibrillation (AF) in Individuals Aged 65 and Older in Yangzhou, Jiangsu.
From January 1, 2019, to August 31, 2023, an epidemiological cross-sectional survey was conducted among the elderly population undergoing health check-ups at Northern Jiangsu People's Hospital in Jiangsu Province. Patients diagnosed with AF after a 12-lead electrocardiogram were included in the case group, and non-AF individuals matched by age and gender in a 1:4 frequency ratio were included in the control group. Least Absolute Shrinkage and Selection Operator (LASSO) regression was used to select important variables from routine blood tests and biochemical indicators and their derived indicators (such as TyG, TyG-BMI, TG/HDL-c, RAR, NLR, MHR). Based on the selected variables, participants were divided into four groups (Q1 ~ Q4), and multifactorial Logistic regression analysis, restricted cubic spline regression, gender subgroup analysis and Receiver Operating Characteristic (ROC) curve were used to explore the relationship between the relevant variables and AF.
A total of 5,879 elderly individuals over the age of 65 were included in the study, with a prevalence of AF of 2.96% (174/5,879). The prevalence of AF in the overall population, as well as in male and female populations, showed a continuous increasing trend with age (P for trend < 0.001). A total of 696 individuals without AF after matching served as the control group, and LASSO regression identified albumin, direct bilirubin, and uric acid as three significant indicators. After adjusting for relevant confounding factors, lower levels of albumin, and higher levels of direct bilirubin and uric acid were significantly associated with the occurrence of AF (P < 0.05). Gender subgroup analysis revealed that in the elderly female population, albumin was not significantly associated with AF (P > 0.05), while direct bilirubin and uric acid were significantly associated with AF (P < 0.05). In the male population, albumin, direct bilirubin, and uric acid were significantly associated with AF (P < 0.05). Restricted cubic spline regression analysis showed a significant nonlinear relationship between direct bilirubin and AF (P for nonlinear < 0.001). The ROC curve analysis indicates that albumin, direct bilirubin, and uric acid all have good association strength with AF in elderly patients, with direct bilirubin showing the strongest association effect (AUC (95% CI) = 0.728 (0.686, 0.769)).
Low levels of albumin, high levels of direct bilirubin, and uric acid are all significantly associated with AF in the elderly population of the Central Jiangsu region. The conclusions of this study need further validation with a larger sample size.
本研究旨在探讨江苏省扬州市65岁及以上人群血液检测指标与心房颤动（AF）之间的相关性。
2019年1月1日至2023年8月31日，对在江苏省苏北人民医院接受健康体检的老年人群进行了一项流行病学横断面调查。经12导联心电图诊断为AF的患者纳入病例组，按年龄和性别以1:4的频率比匹配的非AF个体纳入对照组。采用最小绝对收缩和选择算子（LASSO）回归从常规血液检测和生化指标及其衍生指标（如TyG、TyG-BMI、TG/HDL-c、RAR、NLR、MHR）中筛选重要变量。基于所选变量，将参与者分为四组（Q1~Q4），并采用多因素Logistic回归分析、受限立方样条回归、性别亚组分析和受试者工作特征（ROC）曲线来探讨相关变量与AF之间的关系。
本研究共纳入5879名65岁以上的老年人，AF患病率为2.96%（174/5879）。总体人群以及男性和女性人群中AF的患病率均随年龄呈持续上升趋势（趋势P<0.001）。共有696名匹配后无AF的个体作为对照组，LASSO回归确定白蛋白、直接胆红素和尿酸为三个显著指标。在调整相关混杂因素后，较低的白蛋白水平以及较高的直接胆红素和尿酸水平与AF的发生显著相关（P<0.05）。性别亚组分析显示，在老年女性人群中，白蛋白与AF无显著相关性（P>0.05），而直接胆红素和尿酸与AF显著相关（P<0.05）。在男性人群中，白蛋白、直接胆红素和尿酸与AF显著相关（P<0.05）。受限立方样条回归分析显示直接胆红素与AF之间存在显著的非线性关系（非线性P<0.001）。ROC曲线分析表明，白蛋白、直接胆红素和尿酸在老年患者中与AF均具有良好的关联强度，其中直接胆红素的关联效应最强（AUC（95%CI）=0.728（0.686，0.769））。
苏中地区老年人群中低白蛋白水平、高直接胆红素水平和高尿酸水平均与AF显著相关。本研究结论需要更大样本量进一步验证。
