Arrhythmias and conduction disturbanceMeta-Analysis of Cohort and Case–Control Studies of Type 2 Diabetes Mellitus and Risk of Atrial Fibrillation
Section snippets
Methods
We performed a systematic review of the available literature according to Meta-Analysis Of Observational Studies in Epidemiology (MOOSE) guidelines for the conduct of meta-analyses of observational studies.6 Relevant studies were identified by computerized searches from the following data sources: MEDLINE via Ovid (from 1950 through April 2010) and EMBASE (from 1966 through May 2010) using relevant text words and medical subject headings that included all spellings of “type 2 diabetes” or
Results
Six prospective cohort studies relating DM to subsequent risk of AF involving 5,436 incident cases of AF in 801,837 patients were identified.1, 11, 12, 13, 14, 15 An additional cohort including 265 incident cases of AF in 28,449 patients reported on the association between impaired glucose tolerance and risk of AF16 (Table 1). Three of the 7 cohort studies provided gender-specific estimates adjusted at least for age of the association between DM and AF; thus, 10 separate estimates of the
Discussion
In this meta-analysis involving information on 108,703 cases of AF in 1,686,097 patients from 7 prospective cohort and 4 case–control studies, DM was associated with an overall 34% increase in risk of AF after correcting for presence of publication bias. Summary estimates for the cohort and case–control studies were broadly similar, although lack of a significant difference among study designs may have been caused by the meta-regression analysis being underpowered.
However, the overall summary
Acknowledgment
The authors are grateful to Aaron Folsom and Faye Lopez for their critical revision of this report. Dr. Huxley had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
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