Background

There is an increasing body of evidence associating traditional cardiovascular risk factors with atrial fibrillation (AF), but the relationship between blood lipid profiles and the risk of AF remains controversial.

Objective

This study aimed to conduct a systemic review and meta-analysis of large cohort studies to evaluate the relationship between blood lipid profiles and incident AF.

Methods

PubMed and Embase were searched up to January 31, 2019, for cohort studies that reported the relationship between blood lipid levels and incident AF. The hazard ratios or odds ratios of the highest vs lowest categories of lipid levels were extracted to calculate pooled estimates. Sensitivity analysis and meta-regression were performed to explore potential sources of heterogeneity.

Results

Eleven studies were included in the meta-analysis, including 9 studies for total cholesterol (TC), 5 for low-density lipoprotein cholesterol (LDL-C), 8 for high-density lipoprotein cholesterol (HDL-C), and 8 for triglyceride. Serum TC and LDL-C levels were inversely related to AF risk (relative risk [RR] = 0.81, 95% confidence interval [CI]: 0.72–0.92; RR = 0.79, 95% CI: 0.70–0.88, respectively). Likewise, elevated HDL-C levels were associated with a reduced AF risk (RR = 0.86, 95% CI: 0.76–0.97), whereas no significant association was observed between triglyceride levels and incident AF (RR = 1.02, 95% CI: 0.90–1.17).

Conclusions

Our meta-analysis of large cohort studies found an inverse relationship between serum TC, LDL-C, and HDL-C levels and AF risk, although there was no significant association between TG levels and incident AF. Future studies regarding AF risk stratification may take these blood lipids into consideration, and further efforts are needed to investigate the potential mechanisms.

中文翻译：

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血脂水平和房颤风险：队列研究的系统评价和荟萃分析。

背景

越来越多的证据将传统的心血管危险因素与心房颤动（AF）相关联，但是血脂谱与AF风险之间的关系仍然存在争议。

客观的

这项研究的目的是对大型队列研究进行系统的回顾和荟萃分析，以评估血脂谱与入射房颤之间的关系。

方法

截至2019年1月31日，已对PubMed和Embase进行了搜索，以进行队列研究，该研究报告了血脂水平与入射房颤之间的关系。提取最高和最低类别的脂质水平的危险比或比值比，以计算合并的估计值。进行了敏感性分析和Meta回归，以探究异质性的潜在来源。

结果

荟萃分析包括11项研究，包括9项针对总胆固醇（TC）的研究，5项针对低密度脂蛋白胆固醇（LDL-C）的研究，8项针对高密度脂蛋白胆固醇（HDL-C）的研究和8项甘油三酸酯的研究。血清TC和LDL-C水平与房颤风险呈负相关（相对风险[RR] = 0.81，95％置信区间[CI]：0.72-0.92； RR = 0.79，95％CI：0.70-0.88）。同样，HDL-C水平升高与房颤风险降低相关（RR = 0.86，95％CI：0.76-0.97），而甘油三酸酯水平与入射房颤之间没有显着相关性（RR = 1.02，95％CI：0.90） –1.17）。

结论

我们对大型队列研究的荟萃分析发现，血清TC，LDL-C和HDL-C水平与房颤风险之间存在反比关系，尽管TG水平与入射房颤之间无显着关联。关于房颤风险分层的未来研究可能会考虑这些血脂，需要进一步努力研究潜在的机制。