According to Thomas A. Agbaedeng and collaborating researchers, the underlying mechanisms of overweight and obese status that drive their association with increased risk of atrial fibrillation (AF) are not well-understood. The group performed a literature review and analysis, and ultimately concluded that “adipokines, principally adiponectin, apelin, and resistin, are associated with the risk of atrial fibrillation.” However, these associations were not confirmed in multivariate analysis; a finding that the researchers considered was likely due to a lack of statistical power. The results were published in Nutrition, Metabolism, and Cardiovascular Diseases.
The analysts collected a total of 34 studies, encompassing 31,479 patients, which reported on adipokine and AF, as well as overall prevalent or incident AF and AF subtypes (paroxysmal, persistent, or non-paroxysmal AF). The authors found that the adipokines apelin (prevalent AF risk ratio [RR] = 0.05; 95% confidence interval [CI], 0.00-0.50; p = 0.01; recurrent AF RR = 0.21; 95% CI, 0.11–0.42; p <0.01) and resistin (incident AF RR = 2.05; 95% CI, 1.02–4.1; p = 0.04; prevalent AF RR = 2.62; 95% CI, 1.78–3.85; p <0.01) were associated with AF.
Researchers also stated that pooled multivariable analyses indicated adiponectin as the sole independent predictor of AF incidence (p = 0.02), and that adiponectin was associated with non-paroxysmal AF (p = 0.01).
In summary, the authors wrote that adiponectin, chemerin, resistin, and visfatin were associated with increased AF risk, but acknowledged that larger studies on these relationships are needed to determine “how they can refine AF monitoring strategies.”