Cho So Hyun, Kim Gyuri, Lee Kyu-Na, Oh Rosa, Kim Ji Yoon, Jang Myunghwa, Lee You-Bin, Jin Sang-Man, Hur Kyu Yeon, Han Kyungdo, Kim Jae Hyeon
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
Department of Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Sci Rep. 2025 Apr 3;15(1):11430. doi: 10.1038/s41598-025-94783-8.
This study aims to investigate the incidence of new-onset atrial fibrillation (AF) in individuals with type 2 diabetes mellitus (T2DM) across different categories of steatotic liver disease (SLD). Using a health examination database between 2009 and 2012, this study included 2,480,880 patients. Participants were categorized into five groups based on hepatic steatosis (fatty liver index ≥ 60), cardiometabolic risk factors, and alcohol consumption. Cox regression analyses were performed. The metabolic dysfunction-associated steatotic liver disease (MASLD) group showed an increased risk of new-onset AF (adjusted hazard ratio (aHR), 1.10; 95% confidence interval (CI), 1.08-1.11). The MASLD with other combined group demonstrated increased AF development (aHR, 1.22; 95% CI, 1.18-1.26). In metabolic dysfunction and alcohol-related steatotic liver disease (MetALD) and alcohol-related liver disease (ALD) with metabolic groups, heavy to excessive alcohol consumption increased the risk of AF incidence, with the highest aHR associated with greater alcohol intake (aHR, 1.26; 95% CI, 1.22-1.29, 1.48; 95% CI, 1.41-1.55). MASLD increased the risk of AF in patients with T2DM, with a higher risk observed when accompanied by other liver diseases. Alcohol consumption was associated with proportional increase in the risk of AF, with excessive alcohol consumption associated with the highest risk of AF.
本研究旨在调查2型糖尿病（T2DM）患者中不同类型脂肪性肝病（SLD）新发房颤（AF）的发生率。利用2009年至2012年的健康检查数据库，本研究纳入了2480880名患者。参与者根据肝脂肪变性（脂肪肝指数≥60）、心血管代谢危险因素和饮酒情况分为五组。进行了Cox回归分析。代谢功能障碍相关脂肪性肝病（MASLD）组新发房颤的风险增加（调整后风险比（aHR），1.10；95%置信区间（CI），1.08 - 1.11）。MASLD合并其他疾病组房颤发生率增加（aHR，1.22；95%CI，1.18 - 1.26）。在代谢功能障碍和酒精相关脂肪性肝病（MetALD）以及代谢组的酒精性肝病（ALD）中，重度至过量饮酒增加了房颤发生风险，酒精摄入量越高，aHR越高（aHR，1.26；95%CI，1.22 - 1.29，1.48；95%CI，1.41 - 1.55）。MASLD增加了T2DM患者房颤风险，合并其他肝病时风险更高。饮酒与房颤风险成比例增加相关，过量饮酒与房颤最高风险相关。
