Interrelationships between diabetes and atrial fibrillation: Comparative assessment of clinical markers and possible therapeutic implications.

BACKGROUND AND AIMS: Type 2 diabetes mellitus (DM) is a modifiable risk factor for atrial fibrillation (AF). Some fibrotic and inflammatory markers associated with DM may contribute to structural fibrosis and electrical remodeling in AF. This cross-sectional study aimed to assess the pathophysiological interrelationships between DM and AF by comparing diverse circulating and cardiac structural markers in patients diagnosed with either condition or both.

METHODS AND

RESULTS

Data were collected retrospectively from the medical records of 647 eligible adults: DM group (n = 192, mean age 55 years), AF group (n = 160, 61.8 years), AF+DM group (n = 154, 64.2 years), and control group (n = 141, 51.2 years). Additional biomarkers (transforming growth factor-β1 (TGF-β1) and glycated albumin) were determined from blood specimens in a subgroup of participants. AF patients exhibited lower levels of HDL, LDL and total cholesterol relative to controls, regardless of DM status. LDL-cholesterol was significantly more depressed in AF patients, particularly those with co-occurring DM. Triglyceride, fasting plasma glucose and HbA1c levels did not differ in the AF and control groups, and were the highest in the DM group, followed by AF+DM patients. TGF-β1 was depressed in AF patients, in contrast to its moderate level in AF+DM patients. Creatinine was significantly more elevated in AF patients, especially those with DM. AF patients also exhibited left atrial and ventricular enlargement, whether or not DM co-occurred.

CONCLUSIONS

Findings suggest differential relationships between DM and AF with additive or interactive effects on some markers, including LDL, creatinine and TGF-β1, which could result in excess risk of adverse outcomes.