Metabolic Syndrome and the Risk of New-Onset Atrial Fibrillation in Middle-Aged East Asian Men

Abstract

Background: The components of metabolic syndrome have been implicated in the development of atrial fibrillation (AF). Although the prevalence of AF has been increasing in East Asia, the association between metabolic syndrome and AF is uncertain. This study aimed to determine the association between metabolic syndrome and AF in middle-aged East Asian men. Methods: A total of 24,741 middle-aged Korean men without baseline AF were enrolled in a health screening program from January 2003 to December 2008. Among them, 21,981 subjects were evaluated to determine the risk of AF based on baseline metabolic syndrome status through December 2016. At every visit, the subjects were evaluated for AF using electrocardiography. Metabolic syndrome was defined using the criteria of the International Diabetes Federation. Results: Metabolic syndrome was present in 2,529 subjects (11.5 %). Mean (± standard deviation) age was 45.9 ± 5.3 years. During a mean follow-up of 8.7 years, 168 subjects (0.8%) were diagnosed with AF. The age-adjusted and multivariate-adjusted hazard ratios (HR) for metabolic syndrome with AF were 1.62 (95% confidence interval [CI] 1.08-2.44, p=0.02) and 1.57 (95% CI 1.04-2.38, p=0.03), respectively. Among the components of metabolic syndrome, central obesity (age-adjusted HR 1.62, 95% CI 1.14-2.29, p<0.01) and raised blood pressure (age-adjusted HR 1.43, 95% CI 1.05-1.94, p=0.02) were associated with an increased risk of AF. Conclusions: Metabolic syndrome is associated with an increased risk of AF in middle-aged East Asian men. Of the components of metabolic syndrome, central obesity is the most potent risk factor for the development of AF in this population.