ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Clinical Diabetes
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1461613
This article is part of the Research TopicDigital Technology in the Management and Prevention of Diabetes: Volume IIView all 17 articles
Inverse association between remnant cholesterol and risks of atrial fibrillation among patients with type 2 diabetes
Provisionally accepted
- 1The Affiliated Hospital of Qingdao University, Qingdao, China
- 2Qingdao Central Hospital, Qingdao, Shandong Province, China
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We aimed to investigate the association between remnant cholesterol (RC) levels and the risk of atrial fibrillation (AF) among patients with type 2 diabetes, by leveraging data from a large cohort of diabetic patients.We included patients with T2DM who received routine care at the affiliated hospital of Qingdao University between January 2014 and December 2023. A total of 9930 patients remained eligible for the final analysis. The primary outcome of this study was the incidence of atrial fibrillation.Results: During a mean follow up of 6.12 ± 2.75 years, a total of 1,028 AF events occurred. Cox proportional hazards regression was performed to obtain the hazard ratios (HRs) for the incidence of atrial fibrillation by different RC levels at baseline. Compared to Q1, the age-and sex-adjusted HRs for coronary artery disease were 0.89 (95% CI: 0.80-1.28) in Q2, 0.88 (95% CI: 0.80-0.98) in Q3, and 0.76 (95% CI: 0.67-0.84) in Q4. As a continuous variable, RC had an HR of 0.77 (95% CI: 0.64-0.93). After adjusting for age, sex, systolic blood pressure, triglycerides, HbA1c, smoking status, eGFR, and the use of antiplatelet or anticoagulant, lipid-lowering, antihypertensive, and glucoselowering medications, the multivariable-adjusted HRs were 0.92 (95% CI: 0.82-1.32) in Q2, 0.97 (95% CI: 0.88-1.08) in Q3, and 0.88 (95% CI: 0.79-0.98) in Q4. As a continuous variable, RC had an HR of 0.83 (95% CI: 0.66-0.99).We demonstrated an inverse association between RC and incident risk of AF using data from real world retrospectively. Future prospective studies with the best option of an interventional trial are needed to further validate our findings.
Keywords: Atrial Fibrillation, type 2 diabetes mellitus, Remnant cholesterol, cardiovascular disease, Hyperlipidemia
Received: 08 Jul 2024; Accepted: 12 May 2025.
Copyright: © 2025 Jiang, Zhao, Sun, Sun and Pan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jian Sun, The Affiliated Hospital of Qingdao University, Qingdao, China
Shuhan Pan, The Affiliated Hospital of Qingdao University, Qingdao, China
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