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Published on: February 26, 2013
Association of atrial fibrillation with diabetic nephropathy: A meta-analysis
Maha M Arnous1, Aseel A Al Saidan2, Sultan Al Dalbhi3
1Department of Family Medicine, Security Forces Hospital, Jouf University, Sakaka, Aljouf 74311, Saudi Arabia.
Insights
This meta-analysis found no significant link between atrial fibrillation and diabetic nephropathy. Further research with larger sample sizes is needed to confirm these findings on atrial fibrillation risk in diabetic nephropathy patients.
Area of Science:
- Cardiology
- Nephrology
- Endocrinology
Background:
- Diabetes mellitus is linked to increased atrial fibrillation risk.
- Diabetic nephropathy is a common complication of diabetes.
- Existing evidence on the association between diabetic nephropathy and atrial fibrillation is limited.
Purpose of the Study:
- To conduct a meta-analysis investigating the association between diabetic nephropathy and atrial fibrillation.
- To synthesize current evidence on the risk of atrial fibrillation in patients with diabetic nephropathy.
Main Methods:
- A systematic literature search was performed for studies published between January 1995 and November 2020.
- Four studies met the inclusion criteria, involving 307,330 participants.
- Data were analyzed using Cochrane's RevMan 5.3 to calculate a summary odds ratio.
Main Results:
- The meta-analysis included three studies (excluding one cohort study due to differing effect measures), totaling 22,855 diabetic nephropathy patients.
- The summary odds ratio for atrial fibrillation in diabetic nephropathy was 1.32 (0.80-2.18), which was not statistically significant.
- Significant heterogeneity and small sample sizes contributed to a summary estimate shifting towards the null value.
Conclusions:
- The current meta-analysis did not find a statistically significant association between diabetic nephropathy and atrial fibrillation.
- Larger, high-quality studies are necessary to establish a definitive link.
- Further research is warranted to clarify the relationship between these conditions.
Background:
Many studies have provided evidence for an increased risk of atrial fibrillation among diabetic patients as compared to the nondiabetic population. It is also well known that diabetes predisposes a person to an increased risk of diabetic nephropathy. A few reviews and studies have hinted towards an increased risk of atrial fibrillation among diabetic nephropathy patients; however, there is no concrete evidence at present.
Aim:
To conduct a meta-analysis to explore if there is an association between diabetic nephropathy and atrial fibrillation.
Methods:
The available literature was searched for relevant studies from the period of January 1995 to November 2020. The following quality assessment criteria were considered for study shortlisting: clearly defined comparison groups, same outcome measured in both comparison groups, known confounders addressed, and a sufficiently long and complete (more than 80%) follow-up of patients. Two independent reviewers searched the databases, formed their search strategies, and finalized the studies. The data were analyzed to obtain a summary odds ratio along with a forest plot by Cochrane's RevMan 5.3.
Results:
Only four studies were found to meet the inclusion criterion for this meta-analysis (total number of study participants: 307330, diabetic nephropathy patients: 22855). Of these, two were retrospective cross-sectional studies, one was a prospective cohort study, and one was a case-control study. Three studies had provided the odds ratio as the measure of effect (two retrospective cross-sectional studies and one case-control study), with the one cohort study reporting the hazards ratio as the measure of effect. Therefore, the meta-analysis was done excluding the cohort study. The summary odds ratio in the present study was 1.32 (0.80-2.18), which was not statistically significant. Due to large heterogeneity among the included studies and their small sample sizes, it was found that the summary estimate shifted towards the null value.
Conclusion:
The present meta-analysis found no significant association between atrial fibrillation and diabetic nephropathy. However, more studies with large sample sizes are required to strengthen the evidence for an association.
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