title: Insulin resistance and atrial fibrillation (from the Framingham Heart Study).
abstract: Diabetes mellitus and obesity are increasing in prevalence and are associated with an elevated risk of atrial fibrillation (AF). Given the aging of the United States population, AF is projected to concomitantly increase in prevalence in the upcoming decades. Both diabetes and obesity are associated with insulin resistance. Whether insulin resistance is an intermediate step for the development of AF is uncertain. We hypothesized that insulin resistance is associated with an increased risk of incident AF. We examined the association of insulin resistance with incident AF using multivariate Cox proportional hazards regression analysis adjusting for the established AF risk factors (i.e., age, gender, systolic blood pressure, hypertension treatment, PR interval, significant heart murmur, heart failure, and body mass index). Of the 3,023 eligible participants (55% women; mean age 59 years) representing 4,583 person-examinations (Framingham Offspring fifth and seventh examination cycles), 279 participants developed AF (9.3%) within ≤10 years of follow-up. With multivariate modeling, insulin resistance was not significantly associated with incident AF (hazard ratio comparing top quartile to other 3 quartiles of homeostatic model assessment index 1.18, 95% confidence interval 0.84 to 1.65, p = 0.34). In a community-based cohort with ≤10 years of follow-up, no significant association was observed between insulin resistance and incident AF.
authors: National Heart Lung and Blood Institute's and Boston University's Framingham Heart Study, Framingham, Massachusetts, USA.
authors: João D
authors: JD
authors: Fontes
authors: Asya
authors: A
authors: Lyass
authors: Joseph M
authors: JM
authors: Massaro
authors: Michiel
authors: M
authors: Rienstra
authors: Dhayana
authors: D
authors: Dallmeier
authors: Renate B
authors: RB
authors: Schnabel
authors: Thomas J
authors: TJ
authors: Wang
authors: Ramachandran S
authors: RS
authors: Vasan
authors: Steven A
authors: SA
authors: Lubitz
authors: Jared W
authors: JW
authors: Magnani
authors: Daniel
authors: D
authors: Levy
authors: Patrick T
authors: PT
authors: Ellinor
authors: Caroline S
authors: CS
authors: Fox
authors: Emelia J
authors: EJ
authors: Benjamin
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications / Q000453:epidemiology; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D007328:Insulin