title: Elevated glycated hemoglobin levels may increase the risk of atrial fibrillation in patients with diabetes mellitus.
abstract: BACKGROUND
  As the most common cardiac arrhythmia, atrial fibrillation (AF) is always accompanied with various complications if without detection and treatment timely. Blood-based pleiotropic molecule biomarkers have now been popularly applied in clinical detection. We hence performed this meta-analysis to evaluate the correlation of serum glycated hemoglobin (HbA1c) levels with the risk of AF in patients with diabetes mellitus (DM).
  
  
  METHODS
  Covering myriads of computerized databases, we identified potential relevant studies for statistical analysis. We used a standard reporting form to extract data from each included study. Newcastle-Ottawa Scale (NOS) criteria was used for methodological quality assessment. Statistical analyses were conducted with the STATA statistical software.
  
  
  RESULTS
  Six cohort studies in full text fulfilled our inclusion criteria, and following overestimation indicated that serum levels of HbA1c in DM patients with AF was higher than that in DM patients without AF (SMD = 0.67, 95% CI: 0.39-0.94, P < 0.001). Subgroup analyses by sample size and detection method implicated that elevated serum HbA1c levels exhibited significant correlations with an increased risk of AF in DM patients in the large-size subgroup (n ≥ 200), the small-size subgroup (n < 200), the high performance liquid chromatography (HPLC) subgroup and the non-HPLC subgroup (Large-size: SMD = 0.70, 95% CI: 0.38-1.03, P < 0.001; Small-size: SMD = 0.64, 95% CI: 0.09-1.19, P = 0.023; HPLC: SMD = 0.81, 95% CI: 0.49-1.12, P < 0.001; Non-HPLC: SMD = 0.36, 95% CI: 0.04-0.68, P = 0.029; respectively).
  
  
  CONCLUSIONS
  Elevated serum HbA1c levels may be associated with an increased risk of AF in DM patients, possibly reflecting that serum HbA1c level might be a potential biomarker in the prediction of AF in DM patients.
authors.affiliation: Department of Cardiovascular, Zhong Shan Hospital Attached to Fu Dan University Shanghai 200032, P. R. China.
authors.forename: Yu-Fan
authors.initials: YF
authors.lastname: Yang
authors.affiliation: Department of Cardiovascular, Zhong Shan Hospital Attached to Fu Dan University Shanghai 200032, P. R. China.
authors.forename: Wen-Qing
authors.initials: WQ
authors.lastname: Zhu
authors.affiliation: Department of Cardiovascular, Zhong Shan Hospital Attached to Fu Dan University Shanghai 200032, P. R. China.
authors.forename: Kuan
authors.initials: K
authors.lastname: Cheng
authors.affiliation: Department of Cardiovascular, Zhong Shan Hospital Attached to Fu Dan University Shanghai 200032, P. R. China.
authors.forename: Qing-Xing
authors.initials: QX
authors.lastname: Chen
authors.affiliation: Department of Cardiovascular, Zhong Shan Hospital Attached to Fu Dan University Shanghai 200032, P. R. China.
authors.forename: Ye
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Cardiovascular, Zhong Shan Hospital Attached to Fu Dan University Shanghai 200032, P. R. China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Pang
authors.affiliation: Department of Cardiovascular, Zhong Shan Hospital Attached to Fu Dan University Shanghai 200032, P. R. China.
authors.forename: Gui-Jian
authors.initials: GJ
authors.lastname: Liu
authors.affiliation: Department of Cardiovascular, Zhong Shan Hospital Attached to Fu Dan University Shanghai 200032, P. R. China.
authors.forename: Jun-Bo
authors.initials: JB
authors.lastname: Ge
keywords: Glycated hemoglobin; atrial fibrillation; diabetes mellitus; meta-analysis