We systematically searched PubMed, Embase, and Web of Science databases to identify all relevant cohort studies investigating the association between NAFLD/MAFLD and AF published from database inception to October 30, 2022. Random-effects models were utilized to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for summary purposes. Additionally, subgroup and sensitivity analyses were performed.
A total of 13 cohort studies with 14 272 735 participants were included. Among these, 12 cohort studies with 14 213 289 participants (median follow-up of 7.8 years) showed a significant association between NAFLD and an increased risk of incident AF (HR = 1.18, 95% CI: 1.12-1.23, P < 0.00001). Our subgroup analyses mostly yielded similar results, and the results of sensitivity analyses remained unchanged. However, meta-analysis of data from 2 cohort studies with 59 896 participants (median follow-up of 2.15 years) showed that MAFLD was not linked to incident AF (HR = 1.36, 95% CI: 0.63-2.92, P = 0.44).
Current evidence shows that NAFLD may be linked to a slightly higher risk of developing AF, particularly among Asian populations and those diagnosed with NAFLD using FLI criteria. Nevertheless, there is not enough evidence to support the proposed association between MAFLD and an increased risk of AF. To better understand this relationship, future studies should consider factors such as specific population, the severity of NAFLD/MAFLD, diagnostic methods of NAFLD and AF, and cardiometabolic risk factors.
https://www.crd.york.ac.uk/prospero, identifier CRD42022371503.
■我们系统地搜索了PubMed,Embase,和WebofScience数据库,以确定从数据库开始到2022年10月30日发表的所有相关队列研究,调查NAFLD/MAFLD与AF之间的关联。随机效应模型用于计算具有95%置信区间(CI)的风险比(HR),以用于总结目的。此外,我们进行了亚组和敏感性分析.
■共纳入13项队列研究,14272735名参与者。其中,对14213289名参与者(中位随访7.8年)的12项队列研究显示,NAFLD与房颤事件风险增加之间存在显著关联(HR=1.18,95%CI:1.12-1.23,P<0.00001)。我们的亚组分析大多产生类似的结果,敏感性分析的结果保持不变。然而,对来自2项队列研究的数据进行的荟萃分析,包括59896名参与者(中位随访时间为2.15年),结果显示MAFLD与房颤事件无关(HR=1.36,95%CI:0.63-2.92,P=0.44)。
■目前的证据表明,NAFLD可能与发生房颤的风险略高有关。特别是在亚洲人群和使用FLI标准诊断为NAFLD的人群中.然而,没有足够的证据支持MAFLD与AF风险增加之间的关联.为了更好地理解这种关系,未来的研究应该考虑特定人群等因素,NAFLD/MAFLD的严重程度,NAFLD和AF的诊断方法,和心脏代谢危险因素。
■https://www.crd.约克。AC.英国/普劳里,标识符CRD42022371503。