Association between metabolic dysfunction-associated fatty liver disease and supraventricular and ventricular tachyarrhythmias in patients with type 2 diabetes
Association between metabolic dysfunction-associated fatty liver disease and supraventricular and ventricular tachyarrhythmias in patients with type 2 diabetes
Background: Currently, it remains uncertain whether metabolic dysfunction-associated fatty liver disease (MAFLD) is associated with increased risk of supraventricular and ventricular tachyarrhythmias in people with type 2 diabetes mellitus (T2DM). Methods: We retrospectively examined the data of 367 ambulatory patients with T2DM who underwent 24-hour Holter monitoring between 2015 and 2022 for clinical indications, and who did not have pre-existing permanent atrial fibrillation (AF), kidney failure or known liver diseases. Paroxysmal supraventricular tachycardia (PSVT), paroxysmal AF and episodes of ventricular tachyarrhythmias (i.e., presence of ventricular tachycardia, >30 premature ventricular complexes per hour, or both) were recorded. The presence and severity of MAFLD was diagnosed by ultrasonography and fibrosis-4 (FIB-4) index. Results: Patients with T2DM who had MAFLD (n = 238) had a significantly greater prevalence of PSVT (51.7% vs. 38.8%), paroxysmal AF (6.3% vs. 1.3%) and combined ventricular tachyarrhythmias (31.9% vs. 20.2%) compared to their counterparts without MAFLD (n = 129). MAFLD was significantly associated with a greater than two-fold risk of having PSVT (adjusted-odds ratio [OR] 2.04, 95% confidence interval 1.04–4.00) or ventricular tachyarrhythmias (adjusted-OR 2.44, 95%CI 1.16–5.11), after adjusting for age, sex, smoking, alcohol intake, diabetes-related factors, comorbidities, medication use and left ventricular ejection fraction on echocardiography. The risk of supraventricular and ventricular tachyarrhythmias was even greater amongst patients with MAFLD and FIB-4 ≥ 1.3. Conclusions: In ambulatory patients with T2DM, the presence and severity of MAFLD was strongly associated with an increased risk of supraventricular and ventricular arrhythmias on 24-hour Holter monitoring.
Arrhythmias, Cardiovascular disease, MAFLD, Metabolic dysfunction-associated fatty liver disease, NAFLD, Nonalcoholic fatty liver disease, Type 2 diabetes
Mantovani, Alessandro
73cba325-b8a1-4932-8b15-a564d142c353
Csermely, Alessandro
783f1871-94b9-4ae4-ab65-d08b5e15eba6
Taverna, Antonio
a3ef6ecc-0081-46d0-a517-1ebf69fb030a
Cappelli, Davide
a2fb0109-f147-4498-b96c-917d494c8317
Benfari, Giovanni
d7bd1ed0-31b5-4775-930a-6382e088fd87
Bonapace, Stefano
5763b290-22f3-45fc-9aad-aeb926062151
Byrne, Christopher
1370b997-cead-4229-83a7-53301ed2a43c
Targher, Giovanni
94b8a579-c026-47e0-994b-67e750fe5fad
March 2023
Mantovani, Alessandro
73cba325-b8a1-4932-8b15-a564d142c353
Csermely, Alessandro
783f1871-94b9-4ae4-ab65-d08b5e15eba6
Taverna, Antonio
a3ef6ecc-0081-46d0-a517-1ebf69fb030a
Cappelli, Davide
a2fb0109-f147-4498-b96c-917d494c8317
Benfari, Giovanni
d7bd1ed0-31b5-4775-930a-6382e088fd87
Bonapace, Stefano
5763b290-22f3-45fc-9aad-aeb926062151
Byrne, Christopher
1370b997-cead-4229-83a7-53301ed2a43c
Targher, Giovanni
94b8a579-c026-47e0-994b-67e750fe5fad
Mantovani, Alessandro, Csermely, Alessandro, Taverna, Antonio, Cappelli, Davide, Benfari, Giovanni, Bonapace, Stefano, Byrne, Christopher and Targher, Giovanni
(2023)
Association between metabolic dysfunction-associated fatty liver disease and supraventricular and ventricular tachyarrhythmias in patients with type 2 diabetes.
Diabetes & Metabolism, 49 (2), [101416].
(doi:10.1016/j.diabet.2022.101416).
Abstract
Background: Currently, it remains uncertain whether metabolic dysfunction-associated fatty liver disease (MAFLD) is associated with increased risk of supraventricular and ventricular tachyarrhythmias in people with type 2 diabetes mellitus (T2DM). Methods: We retrospectively examined the data of 367 ambulatory patients with T2DM who underwent 24-hour Holter monitoring between 2015 and 2022 for clinical indications, and who did not have pre-existing permanent atrial fibrillation (AF), kidney failure or known liver diseases. Paroxysmal supraventricular tachycardia (PSVT), paroxysmal AF and episodes of ventricular tachyarrhythmias (i.e., presence of ventricular tachycardia, >30 premature ventricular complexes per hour, or both) were recorded. The presence and severity of MAFLD was diagnosed by ultrasonography and fibrosis-4 (FIB-4) index. Results: Patients with T2DM who had MAFLD (n = 238) had a significantly greater prevalence of PSVT (51.7% vs. 38.8%), paroxysmal AF (6.3% vs. 1.3%) and combined ventricular tachyarrhythmias (31.9% vs. 20.2%) compared to their counterparts without MAFLD (n = 129). MAFLD was significantly associated with a greater than two-fold risk of having PSVT (adjusted-odds ratio [OR] 2.04, 95% confidence interval 1.04–4.00) or ventricular tachyarrhythmias (adjusted-OR 2.44, 95%CI 1.16–5.11), after adjusting for age, sex, smoking, alcohol intake, diabetes-related factors, comorbidities, medication use and left ventricular ejection fraction on echocardiography. The risk of supraventricular and ventricular tachyarrhythmias was even greater amongst patients with MAFLD and FIB-4 ≥ 1.3. Conclusions: In ambulatory patients with T2DM, the presence and severity of MAFLD was strongly associated with an increased risk of supraventricular and ventricular arrhythmias on 24-hour Holter monitoring.
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Accepted/In Press date: 23 December 2022
e-pub ahead of print date: 28 December 2022
Published date: March 2023
Additional Information:
Funding Information:
GT is supported in part by grants from the University School of Medicine of Verona, Verona, Italy . CDB is supported in part by the Southampton National Institute for Health and Care (NIHR) Biomedical Research Centre ( IS-BRC-20004 ), UK.
Publisher Copyright:
© 2022 Elsevier Masson SAS
Keywords:
Arrhythmias, Cardiovascular disease, MAFLD, Metabolic dysfunction-associated fatty liver disease, NAFLD, Nonalcoholic fatty liver disease, Type 2 diabetes
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Local EPrints ID: 473801
URI: http://eprints.soton.ac.uk/id/eprint/473801
ISSN: 1262-3636
PURE UUID: c75d1b0e-7efa-428c-94f6-8d9fc568c6dd
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Date deposited: 31 Jan 2023 17:55
Last modified: 17 Mar 2024 07:38
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Author:
Alessandro Mantovani
Author:
Alessandro Csermely
Author:
Antonio Taverna
Author:
Davide Cappelli
Author:
Giovanni Benfari
Author:
Stefano Bonapace
Author:
Giovanni Targher
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