Steatosis Liver Disease Shows Increased Risk of Diabetes for Patients With Atrial Fibrillation
Investigators find that the risk for new-onset diabetes is especially prominent for patients aged 20 to 29 years.
Steatosis liver disease (SLD) is associated with an increased risk of new-onset diabetes for patients with atrial fibrillation, especially for younger adults, according to results of a study published in Cardiovascular Diabetology. The study authors call for management strategies for patients with AF and SLD to mitigate the risk of diabetes and the impact on AF outcomes.1
Investigators find that the risk for new-onset diabetes is especially prominent for patients aged 20 to 29 years. | Image Credit: mi_viri - stock.adobe.com
Type 2 diabetes (T2D) is closely related to AF and is an independent risk factor. Concurrent AD and T2D have also been linked with high mortality, according to authors of a study published in World Journal of Diabetes. Patients with SLD, such as metabolic dysfunction-associated SLD (MASLD), also show a higher risk of new-onset AF, especially for those aged 20 to 29 years.2,3
In addition to the associations between the 3, the American Diabetes Association published a call to action regarding MASLD and the risk of T2D. They stated, “Driven by insulin resistance, whether lean or obese, steatohepatitis develops in at least half of all people with type 2 diabetes and is a significant risk factor for future cirrhosis, even for individuals without obesity.” They said that promoting liver health is essential, calling for screening for and educating about liver disease, as these have proven to reduce morbidity and mortality from diabetes.4
In the current study, investigators aimed to determine the risk of diabetes across different SLD subtypes, including MASLD, MASLD with increased alcohol intake (MetALD), and alcohol-related liver disease (ALD). The study investigators included patients who developed AF between January 1, 2010, and December 31, 2018, and were included in the National Health Insurance Service of South Korea. Patients were excluded if they were under the age of 20 years, had missing data, and did not undergo regular health check-ups within 2 years before their AF diagnosis.1
Investigators included a total of 195,195 patients with AD, who had a mean age of 64.4 years and 57.5% were men. There was a median follow-up duration of 6 years, and 13% were newly diagnosed with diabetes. Approximately 55.8% did not have an SLD, 36.8% had MASLD, 3.9% had MetALD, and 3.5% had ALD, according to the study authors. There were 10,013 patients in the nonSLD group diagnosed with diabetes, 12,939 were diagnosed in the MASLD group, 1195 were in the MetALD group, and 1215 were in the ALD group. The study authors said that all 3 SLD groups had an increased risk of the incident of diabetes compared with the nonSLD group, but MetALD had a slightly lower risk compared with MASLD and ALD.1
Additionally, the risk of newly diagnosed diabetes in the SLD group had younger patients compared with the nonSLD group, and the hazard ratio generally decreased with age. Patients in the 20-to-39-year range in the SLD groups had an approximate 5- to 7-fold higher risk of diabetes compared to those in the nonSLD group. Further patients in the 40-to-49-year range and 50-to-59-year range had a 3-fold and greater than 2-fold risk, respectively.1
“This large, nationwide population-based study demonstrated that among AF patients, those with MASLD, MetALD, or ALD have approximately double the risk of developing DM compared to those without SLD, and this risk is even more pronounced in younger AF patients,” the study authors wrote. “Considering the increased complication rates associated with concurrent AF and DM, implementing management strategies to prevent DM in AF patients with SLD could potentially mitigate the risk of DM and its potential impact on AF-related outcomes.”1
READ MORE: Diabetes Resource Center
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