P5666Impact of metabolic syndrome on the incidence of atrial fibrillation; a nationwide longitudinal cohort study in South Korea

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
C H Kwon
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
National Health ◽  
Central Obesity ◽  
Fasting Glucose ◽  
Elevated Blood Pressure ◽  
Elevated Blood ◽  
Increased Risk ◽  
The Status

Abstract Background/Introduction There is a lack of studies for the association between the status of metabolic syndrome (MetS) and the risk of atrial fibrillation (AF) Purpose The present study aimed to evaluate the impact of MetS status for the incidence of AF in Korean population. Methods We used the data obtained from the Korean National Health Insurance Service from 2009 to 2016. This study enrolled a total of 7,830,602 men and women aged between 30 and 69 years without baseline AF who underwent national health examination between January 2009 and December 2009. They were evaluated to determine the risk of AF based on the status of MetS until December 2016. Based on the criteria of the National Cholesterol Education Program Adult Treatment Panel III, the status of MetS was defined into three groups according to number of MetS components: the normal (0), Pre-MetS (1–2), and MetS (3–5). Results During follow-up, 20,708 subjects (0.26%) were diagnosed with AF. After multivariable adjustment, the risk of AF was significantly higher according to the status of MetS (hazard ratios [HR] 1.391, 95% confidence interval [CI] 1.322–1.464 in Pre-MetS and HR 1.722, 95% CI 1.621–1.829 in MetS). Among the components of MetS, central obesity (HR 1.316, P<0.001), elevated blood pressure (HR 1.451, P<0.001), and elevated fasting glucose (HR 1.163, P<0.001) were associated with an increased risk of AF. Conclusion MetS and pre-MetS are significantly associated with an increased risk of AF in Korean adults. Of the components of MetS, central obesity, elevated blood pressure, and elevated fasting glucose are potent risk factors for the risk of AF in this population.

scholarly journals The Impact of Metabolic Syndrome on the Incidence of Atrial Fibrillation: A Nationwide Longitudinal Cohort Study in South Korea

2019 ◽  
Vol 8 (8) ◽  
pp. 1095 ◽  
Author(s):  
Kwon ◽  
Kim ◽  
Kim ◽  
Kim ◽  
Kim ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Abdominal Obesity ◽  
National Health ◽  
Fasting Glucose ◽  
Elevated Blood Pressure ◽  
Elevated Blood ◽  
Increased Risk ◽  
The Impact

Aims: To evaluate the impact of metabolic syndrome (MetS) status on the incidence of atrial fibrillation (AF) in Koreans. Methods and results: Data obtained from the Korean National Health Insurance Service from 2009 to 2016 were analyzed. In total, 7,830,602 men and women (between 30 and 69 years of age) without baseline AF who underwent a national health examination between January 2009 and December 2009 were enrolled. Patients were evaluated to determine the impact of MetS status on their risk of developing AF until December 2016. Using the National Cholesterol Education Program Adult Treatment Panel III criteria, patients were placed into one of three groups depending on MetS component numbers: 0 (normal), 1–2 (Pre-MetS) or 3–5 (MetS). During a mean follow-up of 7.3 years, 20,708 subjects (0.26%) were diagnosed with AF. After multivariable adjustment, the risk of AF was significantly and positively correlated with MetS status (hazard ratios (HR) 1.391, 95% confidence interval (CI) 1.322–1.464 in Pre-MetS and HR 1.722, 95% CI 1.621–1.829 in MetS). When subgroup analyses were conducted according to MetS components, abdominal obesity (HR 1.316, p < 0.001), elevated blood pressure (HR 1.451, p < 0.001), and elevated fasting glucose (HR 1.163, p < 0.001) were associated with an increased risk of AF. Conclusion: MetS and pre-MetS are significantly associated with an increased risk of AF in Korean adults. Of the MetS components, abdominal obesity, elevated blood pressure, and elevated fasting glucose are potent risk factors for the risk of AF in this population.

scholarly journals Meta-analysis of metabolic syndrome and its individual components with risk of atrial fibrillation in different populations

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ying Zheng ◽  
Zengshuo Xie ◽  
Jiayong Li ◽  
Chen Chen ◽  
Wenting Cai ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Abdominal Obesity ◽  
Fasting Glucose ◽  
Meta Analysis ◽  
Elevated Blood Pressure ◽  
Cochrane Library ◽  
Elevated Blood ◽  
Increased Risk

Abstract Background Recent studies have reported the effects of metabolic syndrome (MetS) and its components on atrial fibrillation (AF), but the results remain controversial. Therefore, we performed a meta-analysis to evaluate the relationship between MetS and AF risk. Methods Studies were searched from the Cochrane library, PubMed, and Embase databases through May 2020. Adjusted hazard ratios (HRs) and its corresponding 95% confidence intervals (CIs) were extracted and then pooled by using a random effects model. Results A total of 6 observational cohort studies were finally included. In the pooled analysis, MetS was associated with an increased risk of AF (HR 1.57; 95% CI 1.40–1.77; P < 0.01). And the components of MetS including abdominal obesity (HR 1.37; 95% CI 1.36–1.38; P < 0.01), elevated blood pressure (HR 1.56; 95% CI 1.46–1.66; P < 0.01), elevated fasting glucose (HR 1.18; 95% CI 1.15–1.21; P < 0.01) and low high density cholesterol (HDL) (HR 1.18; 95% CI 1.06–1.32; P < 0.01) was also associated with an increased risk of AF, while high triglyceride (HR 0.99; 95% CI 0.87–1.11, P = 0.82) was not. Conclusions Our present meta-analysis suggested that MetS, as well as its components including abdominal obesity, elevated blood pressure, elevated fasting glucose and low HDL cholesterol were associated with an increase in the risk of AF.

scholarly journals High TSH Level within Normal Range Is Associated with Obesity, Dyslipidemia, Hypertension, Inflammation, Hypercoagulability, and the Metabolic Syndrome: A Novel Cardiometabolic Marker

2019 ◽  
Vol 8 (6) ◽  
pp. 817 ◽  
Author(s):  
Yi-Cheng Chang ◽  
Shih-Che Hua ◽  
Chia-Hsuin Chang ◽  
Wei-Yi Kao ◽  
Hsiao-Lin Lee ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Central Obesity ◽  
Cardiometabolic Risk ◽  
Fasting Glucose ◽  
Reference Group ◽  
Elevated Blood ◽  
Normal Range ◽  
The Metabolic Syndrome

(1) Background: Overt and subclinical hypothyroidism has been associated with increased cardiometabolic risks. Here we further explore whether thyroid function within normal range is associated with cardiometabolic risk factors in a large population-based study. (2) Methods: We screened 24,765 adults participating in health examinations in Taiwan. Participants were grouped according to high-sensitive thyroid-stimulating hormone (hsTSH) level as: <50th percentile (0.47–1.48 mIU/L, the reference group), 50–60th percentile (1.49–1.68 mIU/L), 60–70th percentile (1.69–1.94 mIU/L), 70–80th percentile (1.95–2.3 mIU/L), 80–90th percentile (2.31–2.93 mIU/L), and >90th percentile (>2.93 mIU/L). Cardiometabolic traits of each percentile were compared with the reference group. (3) Results: Elevated hsTSH levels within normal range were dose-dependently associated with increased body mass index, body fat percentage, waist circumferences, blood pressure, hemoglobin A1c (HbA1c), fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR), high homeostasis model of assessment of beta-cell (HOMA-β), triglycerides, total cholesterols, fibrinogen, and uric acids (p-for-trend <0.001), but not with fasting glucose levels. The association remained significant after adjustment of age, sex, and lifestyle. As compared to the reference group, subjects with the highest hsTSH percentile had significantly increased risk of being overweight (adjusted odds ratio (adjOR): 1.35), increased body fat (adjOR: 1.29), central obesity (adjOR: 1.36), elevated blood pressure (adjOR: 1.26), high HbA1c (adjOR: 1.20), hyperinsulinemia (adjOR: 1.75), increased HOMA-IR (adjOR: 1.45), increased HOMA-β (adjOR: 1.40), hypertriglyceridemia (adjOR: 1.60), hypercholesterolemia (adjOR: 1.25), elevated hsCRP (adjOR: 1.34), increased fibrinogen (adjOR: 1.45), hyperuricemia (adjOR: 1.47), and metabolic syndrome (adjOR: 1.42), but significant risk of low fasting glucose (adjOR: 0.89). Mediation analysis indicates that insulin resistance mediates the majority of the association between thyroid hormone status and the metabolic syndrome. (4) Conclusion: Elevated hsTSH within the normal range is a cardiometabolic risk marker associated with central obesity, insulin resistance, elevated blood pressure, dyslipidemia, hyperuricemia, inflammation, and hypercoagulability.

scholarly journals Association between 24 h urinary sodium and potassium excretion and the metabolic syndrome in Chinese adults: the Shandong and Ministry of Health Action on Salt and Hypertension (SMASH) study

2015 ◽  
Vol 113 (6) ◽  
pp. 996-1002 ◽  
Author(s):  
Zeng Ge ◽  
Xiaolei Guo ◽  
Xiaorong Chen ◽  
Junli Tang ◽  
Liuxia Yan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Central Obesity ◽  
Hdl Cholesterol ◽  
Elevated Blood Pressure ◽  
Potassium Excretion ◽  
Elevated Blood ◽  
Chinese Adults ◽  
The Metabolic Syndrome ◽  
Low Hdl

The association of 24 h urinary Na and potassium excretion with the risk of the metabolic syndrome (MetS) has not been studied in China. The aim of the present study was to examine this association by analysing the data from 1906 study participants living in north China. To this end, 24 h urine samples were collected. Of the 1906 participants, 471 (24·7 %) had the MetS. The mean urinary Na and K excretion was 228·7 and 40·8 mmol/d, respectively. After multivariate adjustment, the odds of the MetS significantly increased across the increasing tertiles of urinary Na excretion (1·00, 1·40 and 1·54, respectively). For the components of the MetS, the odds of central obesity, elevated blood pressure and elevated TAG, but not the odds of low HDL-cholesterol and elevated fasting glucose, significantly increased with the successive tertiles of urinary Na excretion. Furthermore, for every 100 mmol/d increase in urinary Na excretion, the odds of the MetS, central obesity, elevated blood pressure and elevated TAG was significantly increased by 29, 63, 22 and 21 %, respectively. However, urinary K excretion was not significantly associated with the risk of the MetS. These findings suggest that high Na intake might be an important risk factor for the MetS in Chinese adults.

scholarly journals Na+-sensitive elevation in blood pressure is ENaC independent in diet-induced obesity and insulin resistance

2016 ◽  
Vol 310 (9) ◽  
pp. F812-F820 ◽  
Author(s):  
Jonathan M. Nizar ◽  
Wuxing Dong ◽  
Robert B. McClellan ◽  
Mariana Labarca ◽  
Yuehan Zhou ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Elevated Blood Pressure ◽  
Elevated Blood ◽  
High Fat ◽  
Electrolyte Excretion ◽  
Diet Induced Obesity ◽  
Collecting Ducts ◽  
Fat Feeding

The majority of patients with obesity, insulin resistance, and metabolic syndrome have hypertension, but the mechanisms of hypertension are poorly understood. In these patients, impaired sodium excretion is critical for the genesis of Na+-sensitive hypertension, and prior studies have proposed a role for the epithelial Na+ channel (ENaC) in this syndrome. We characterized high fat-fed mice as a model in which to study the contribution of ENaC-mediated Na+ reabsorption in obesity and insulin resistance. High fat-fed mice demonstrated impaired Na+ excretion and elevated blood pressure, which was significantly higher on a high-Na+ diet compared with low fat-fed control mice. However, high fat-fed mice had no increase in ENaC activity as measured by Na+ transport across microperfused cortical collecting ducts, electrolyte excretion, or blood pressure. In addition, we found no difference in endogenous urinary aldosterone excretion between groups on a normal or high-Na+ diet. High fat-fed mice provide a model of metabolic syndrome, recapitulating obesity, insulin resistance, impaired natriuresis, and a Na+-sensitive elevation in blood pressure. Surprisingly, in contrast to previous studies, our data demonstrate that high fat feeding of mice impairs natriuresis and produces elevated blood pressure that is independent of ENaC activity and likely caused by increased Na+ reabsorption upstream of the aldosterone-sensitive distal nephron.

scholarly journals The association between serum copper concentrations and elevated blood pressure in US children and adolescents: National Health and Nutrition Examination Survey 2011–2016

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Changsong Liu ◽  
Yanfen Liao ◽  
Zongyuan Zhu ◽  
Lili Yang ◽  
Qin Zhang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Children And Adolescents ◽  
National Health ◽  
Serum Copper ◽  
Elevated Blood Pressure ◽  
Nutrition Examination Survey ◽  
Elevated Blood ◽  
Cross Sectional ◽  
Health And Nutrition ◽  
Us Children

Abstract Background Copper is an essential trace metal with potential interest for cardiovascular effects. Few studies have explored the association between copper and blood pressure in children and adolescents. Method We conducted a cross-sectional analysis of 1242 children and adolescents aged 8–17 years who participated in the 2011 to 2016 National Health and Nutrition Examination Survey. Using 2017 American Academy of Pediatrics guidelines, elevated blood pressure (EBP) was defined as a mean systolic and/or diastolic blood pressure (BP) ≥ 90th percentile for sex, age, and height for children aged 1–12 years and systolic BP ≥ 120 mmHg or diastolic BP ≥ 80 mmHg for adolescent age 13–17 years. Mean serum copper was 114.17 μg/dL. Results After multiple adjustments, dose–response analyses revealed that EBP was associated with progressively higher serum copper concentrations in a nonlinear trend. In comparison with the lowest quartile of serum copper concentrations, the adjusted odds of EBP for the highest quartile was 5.26 (95% confidence interval, 2.76–10.03). Conclusion Our results suggested that high serum copper concentrations were significantly associated with EBP in US children and adolescents.

scholarly journals Maternal obesity before pregnancy predicts offspring blood pressure at 18 years of age: A causal mediation analysis

2020 ◽  
Author(s):  
Nicole Brunton ◽  
Brenden Dufault ◽  
Allison Dart ◽  
Meghan B. Azad ◽  
Jonathan M McGavock
Keyword(s):  
Blood Pressure ◽  
Mediation Analysis ◽  
Elevated Blood Pressure ◽  
Childhood And Adolescence ◽  
Elevated Blood ◽  
Causal Mediation ◽  
Increased Risk ◽  
Causal Mediation Analysis ◽  
Maternal Bmi ◽  
Bmi Trajectory

ABSTRACTImportanceHypertension is the second most common pediatric chronic disease in Westernized countries. Understanding the natural history of hypertension is key to identifying prevention strategies.ObjectiveExamine the relationship between maternal pre-pregnancy body mass index (BMI) and offspring blood pressure at 18 years and the mediating role of growth throughout childhood and adolescence.Design, Setting, and ParticipantsWe performed multivariable regression and causal mediation analyses within 3217 mother - offspring pairs from the Avon Longitudinal Study of Parents and Children (ALSAPC) prospective birth cohort. Latent trajectory analysis (LTA) was used to quantify the mediating variable of offspring BMI from 7 to 18 years of age.ExposuresThe main exposure was maternal pre-pregnancy BMI. Analyses were adjusted for relevant confounders including maternal education, maternal blood pressure, and weeks gestation at delivery.Main Outcomes and MeasuresThe main outcome was offspring blood pressure at 18 years of age categorized as normal (SBP < 120 mmHg or DBP < 80mmHg) or elevated (SBP ≥ 120 mmHg or DBP ≥ 80 mmHg) as per the 2017 American Academy of Pediatrics guidelines.ResultsAt 18 years of age, among 3217 offspring, 676 (21%) were overweight or obese, 865 (27%) had elevated blood pressure, and 510 (16%) were hypertensive. LTA identified five distinct offspring BMI trajectories. Multivariate logistic regression revealed that for every 1 unit increase in maternal BMI the risk of elevated blood pressure at 18 years of age increased by 5% (aOR: 1.05, 95% CI: 1.03 – 1.07; p <0.001) and this effect was reduced after adjusting for offspring BMI trajectory (aOR: 1.03, 95% CI: 1.00 – 1.05; p = 0.017). Causal mediation analysis confirmed offspring BMI trajectory as a mediator accounting for 46% of the total effect of maternal BMI on elevated offspring blood pressure (aOR 1.22; 95% CI: 1.07-1.39).Conclusion and RelevanceMaternal BMI prior to pregnancy is associated with an increased risk of elevated blood pressure in offspring at 18 years of age and is mediated, in part, by offspring BMI trajectory throughout childhood and adolescence.

scholarly journals The metabolic syndrome – What is it and how should it be managed?

2019 ◽  
Vol 26 (2_suppl) ◽  
pp. 33-46 ◽  
Author(s):  
Peter M Nilsson ◽  
Jaakko Tuomilehto ◽  
Lars Rydén
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Waist Circumference ◽  
Elevated Blood Pressure ◽  
Elevated Blood ◽  
Successful Management ◽  
Unhealthy Lifestyle ◽  
The Metabolic Syndrome ◽  
Frail Elderly People

A cluster of metabolic factors have been merged into an entity named the metabolic syndrome. Although the characteristics of this syndrome have varied over time the presently used definition was established in 2009. The presence of three abnormal findings out of five components qualifies a person for the metabolic syndrome: elevated waist circumference, elevated triglycerides, reduced high-density lipoprotein cholesterol, elevated blood pressure and elevated fasting plasma glucose. Cut points have been defined for all components apart from waist circumference, for which national or regional values are used. The metabolic syndrome predicts cardiovascular disease and type 2 diabetes. This associated risk does not exceed its components whereof elevated blood pressure is the most frequent. A successful management should, however, address all factors involved. The management is always based on healthy lifestyle choices but has not infrequently to be supported by pharmacological treatment, especially blood pressure lowering drugs. The metabolic syndrome is a useful example of the importance of multiple targets for preventive interventions. To be successful management has to be individualized not the least when it comes to pharmacological therapy. Frail elderly people should not be over-treated. Knowledge transfer of how risk factors act should be accompanied by continuous trust building and motivation. In complex situations with a mix of biological risk factors, adverse social conditions and unhealthy lifestyle, everything cannot be changed at once. It is better to aim for small steps that are lasting than large, unsustainable steps with relapses to unhealthy behaviours. A person with the metabolic syndrome will always be afflicted by its components, which is the reason that management has to be sustained over a very long time. This review summarizes the knowledge on the metabolic syndrome and its management according to present state of the art.

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