ArticleCardiovascular diabetology2021
Cumulative burden of metabolic syndrome and its components on the risk of atrial fibrillation: a nationwide population-based study.
Article in Cardiovascular diabetology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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Who cites it
27 citing papers in PubMed, 45 citations in OpenAlex.
- Disparities in Atrial Fibrillation Metabolic Risk in Indonesia: Time for Sociodemographic Targeted Interventions.JACC. Asia · 2026Article
- Red Cell Distribution Width-Standard Deviation Is Associated with Cumulative Metabolic Burden but Not Independently with Metabolic Syndrome.Medicina (Kaunas, Lithuania) · 2026Observational
- Association between the triglyceride-high-density lipoprotein-glucose-body index and atrial fibrillation: a retrospective case-control study.Frontiers in nutrition · 2026Article
- Dose-response association between metabolic syndrome component count and metabolic dysfunction-associated fatty liver disease, and independent graded association of visceral fat area: a cross-sectional study in a health-checkup population.Frontiers in public health · 2026Article
- Metabolic Syndrome and Atrial Cardiomyopathy on the Risk of Stroke Mortality in the General Population.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2026Article
- Perceived Thermoregulation Dysfunction and Cardiovascular Symptom Burden in Patients with Metabolic Syndrome: A Multicountry Questionnaire-Based Study.Juntendo medical journal · 2026Article
- Atrial fibrillation and metabolic syndrome: an updated review of mechanisms, risk factors, and therapeutic strategies.Frontiers in cardiovascular medicine · 2026Review
- Optimum Patient's Selection for Atrial Fibrillation Ablation Using Echocardiography.Diagnostics (Basel, Switzerland) · 2025Review
- Impact of steatotic liver disease categories on atrial fibrillation in type 2 diabetes: a nationwide study.Scientific reports · 2025Article
- Serum Lipids, Inflammation, and the Risk of Atrial Fibrillation: Pathophysiological Links and Clinical Evidence.Journal of clinical medicine · 2025Review
- Combination of Body Mass Index and Waist Circumference Burden Determines the Risk of Atrial Fibrillation.JACC. Asia · 2025Article
- Revisiting the global burden of atrial fibrillation: associations with obesity and the increased risk of stroke.Archives of medical science : AMS · 2025Article
- A Systematic Review of Metabolic Syndrome: Key Correlated Pathologies and Non-Invasive Diagnostic Approaches.Journal of clinical medicine · 2024Review
- The effect of non-insulin-based insulin resistance indices on the prediction of recurrence in patients with atrial fibrillation undergoing radiofrequency catheter ablation.Cardiovascular diabetology · 2024Article
- Development ofTranslational and clinical pharmacology · 2024Article
- The Metabolic Syndrome, a Human Disease.International journal of molecular sciences · 2024Review
- Cumulative effect of metabolic syndrome on the risk of retinal vein occlusion in young patients: A nationwide population-based study.PloS one · 2024Article
- Higher Cumulative Blood Pressure in Midlife Predicts an Increased Risk of Atrial Fibrillation: Evidence From the Atherosclerosis Risk in Communities Study.Journal of the American Heart Association · 2023Article
- Metabolic disorders and risk of cardiovascular diseases: a two-sample mendelian randomization study.BMC cardiovascular disorders · 2023Article
- Metabolic Syndrome and Atrial Fibrillation: Different Entities or Combined Disorders.Journal of personalized medicine · 2023Review
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe metabolic syndrome (MetS) and its components are associated with the development of atrial fibrillation (AF). However, the impact of time-burden of MetS on the risk of AF is unknown. We investigated the effect of the cumulative longitudinal burden of MetS on the development of AF.
methodsWe included 2 885 189 individuals without AF who underwent four annual health examinations during 2009-2013 from the database of the Korean national health insurance service. Metabolic burdens were evaluated in the following three ways: (1) cumulative number of MetS diagnosed at each health examination (0-4 times); (2) cumulative number of each MetS component diagnosed at each health examination (0-4 times per MetS component); and (3) cumulative number of total MetS components diagnosed at each health examination (0 to a maximum of 20). The risk of AF according to the metabolic burden was estimated using Cox proportional-hazards models.
resultsOf all individuals, 62.4%, 14.8%, 8.7%, 6.5%, and 7.6% met the MetS diagnostic criteria 0, 1, 2, 3, and 4 times, respectively. During a mean follow-up of 5.3 years, the risk of AF showed a positive association with the cumulative number of MetS diagnosed over four health examinations: adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) of 1, 2, 3, and 4 times compared to 0 times were 1.18 (1.13-1.24), 1.31 (1.25-1.39), 1.46 (1.38-1.55), and 1.72 (1.63-1.82), respectively; P for trend < 0.001. All five components of MetS, when diagnosed repeatedly, were independently associated with an increased risk of AF: adjusted HR (95% CI) from 1.22 (1.15-1.29) for impaired fasting glucose to 1.96 (1.87-2.07) for elevated blood pressure. As metabolic components were accumulated from 0 to 20 counts, the risk of AF also gradually increased up to 3.1-fold (adjusted HR 3.11, 95% CI 2.52-3.83 in those with 20 cumulative components of MetS), however, recovery from MetS was linked to a decreased risk of AF.
conclusionsGiven the positive correlations between the cumulative metabolic burdens and the risk of incident AF, maximal effort to detect and correct metabolic derangements even before MetS development might be important to prevent AF and related cardiovascular diseases.
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