title: Hyperuricemia is associated with an increased prevalence of atrial fibrillation in hospitalized patients with type 2 diabetes.
abstract: OBJECTIVE
  Hyperuricemia/gout and atrial fibrillation (AF) are two pathological conditions that are highly prevalent in type 2 diabetes and share multiple cardiovascular risk factors. However, the relationship between elevated levels of serum uric acid and risk of AF in type 2 diabetes is currently poorly known.
  
  
  METHODS
  We studied a hospital-based sample of 842 (male/female = 463/379) patients with type 2 diabetes discharged from our Division of Endocrinology during 2007-2011. Hyperuricemia was defined as a serum uric acid level >7 mg/dl for men and >6 mg/dl for women or allopurinol use. The diagnosis of AF was confirmed in affected participants on the basis of ECGs and medical history by experienced cardiologists.
  
  
  RESULTS
  Overall, 243 (28.9 %) patients had hyperuricemia and 91 (10.8 %) patients had persistent or permanent AF. Compared with those with normal serum uric acid levels, patients with hyperuricemia had a remarkably greater prevalence of AF (20.6 vs. 7.1 %; p < 0.001). Hyperuricemia was significantly associated with an increased risk of prevalent AF (odds ratio 3.41, 95 % CI 2.19-5.32; p < 0.001). Adjustments for age, sex, smoking, hemoglobin A1c, hypertension status, chronic kidney disease, chronic obstructive pulmonary disease and previous histories of hyperthyroidism, ischemic heart disease and valvular heart diseases did not weaken this association (adjusted-odds ratio 6.27, 95 % CI 1.82-21.5; p < 0.01).
  
  
  CONCLUSIONS
  These results indicate that hyperuricemia is associated with an increased prevalence of AF in hospitalized patients with type 2 diabetes, independently of multiple risk factors and potential confounders.
authors.affiliation: Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, Piazzale Stefani, 1, 37126, Verona, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Mantovani
authors.affiliation: Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, Piazzale Stefani, 1, 37126, Verona, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Rigolon
authors.affiliation: Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, Piazzale Stefani, 1, 37126, Verona, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Pichiri
authors.affiliation: Department of Medicine, Section of Cardiology, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Pernigo
authors.affiliation: Department of Medicine, Section of Cardiology, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Bergamini
authors.affiliation: Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, Piazzale Stefani, 1, 37126, Verona, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Zoppini
authors.affiliation: Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, Piazzale Stefani, 1, 37126, Verona, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Bonora
authors.affiliation: Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, Piazzale Stefani, 1, 37126, Verona, Italy. giovanni.targher@univr.it.
authors.forename: G
authors.initials: G
authors.lastname: Targher
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000493:Allopurinol / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications* / Q000453:epidemiology / Q000517:prevention & control; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D058065:Diabetic Cardiomyopathies / Q000150:complications* / Q000453:epidemiology / Q000517:prevention & control; D057286:Electronic Health Records; D005260:Female; D006073:Gout / Q000517:prevention & control; D006074:Gout Suppressants / Q000627:therapeutic use; D006760:Hospitalization; D006785:Hospitals, University; D006801:Humans; D033461:Hyperuricemia / Q000150:complications* / Q000188:drug therapy; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012306:Risk; D014527:Uric Acid / Q000097:blood
chemical_list: D006074:Gout Suppressants; D014527:Uric Acid; D000493:Allopurinol
keywords: Arrhythmia; Atrial fibrillation; Cardiovascular disease; Serum uric acid; Type 2 diabetes