Inverse association between remnant cholesterol and risks of atrial fibrillation among patients with type 2 diabetes

ObjectiveWe 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.MethodsWe included patients with T2DM who received routine care at the af...

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Main Authors: Zeyu Jiang, Kun Zhao, Mengqi Sun, Jian Sun, Shuhan Pan
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2025.1461613/full
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author Zeyu Jiang
Zeyu Jiang
Kun Zhao
Mengqi Sun
Jian Sun
Shuhan Pan
author_facet Zeyu Jiang
Zeyu Jiang
Kun Zhao
Mengqi Sun
Jian Sun
Shuhan Pan
author_sort Zeyu Jiang
collection DOAJ
description ObjectiveWe 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.MethodsWe 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.ResultsDuring 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 glucose-lowering 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).ConclusionsWe 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.
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spelling doaj-art-fe0d25b699f84b70a8fe74ffed238d882025-08-20T02:38:21ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-05-011610.3389/fendo.2025.14616131461613Inverse association between remnant cholesterol and risks of atrial fibrillation among patients with type 2 diabetesZeyu Jiang0Zeyu Jiang1Kun Zhao2Mengqi Sun3Jian Sun4Shuhan Pan5Department of Emergency Medicine, The Affiliated Hospital of Qingdao University, Qingdao, ChinaDepartment of Cardiovascular Medicine, The Affiliated Hospital of Qingdao University, College of Medicine, Qingdao University, Qingdao, ChinaDepartment of Cardiology Medicine, Qingdao Central Hospital, Qingdao, ChinaDepartment of Pathology, The Affiliated Hospital of Qingdao University, Qingdao, ChinaDepartment of Neurosurgical Intensive Care Unit, The Affiliated Hospital of Qingdao University, Qingdao, ChinaDepartment of Emergency Medicine, The Affiliated Hospital of Qingdao University, Qingdao, ChinaObjectiveWe 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.MethodsWe 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.ResultsDuring 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 glucose-lowering 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).ConclusionsWe 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.https://www.frontiersin.org/articles/10.3389/fendo.2025.1461613/fullatrial fibrillationtype 2 diabetes mellitusremnant cholesterolcardiovascular diseasehyperlipidemia
spellingShingle Zeyu Jiang
Zeyu Jiang
Kun Zhao
Mengqi Sun
Jian Sun
Shuhan Pan
Inverse association between remnant cholesterol and risks of atrial fibrillation among patients with type 2 diabetes
Frontiers in Endocrinology
atrial fibrillation
type 2 diabetes mellitus
remnant cholesterol
cardiovascular disease
hyperlipidemia
title Inverse association between remnant cholesterol and risks of atrial fibrillation among patients with type 2 diabetes
title_full Inverse association between remnant cholesterol and risks of atrial fibrillation among patients with type 2 diabetes
title_fullStr Inverse association between remnant cholesterol and risks of atrial fibrillation among patients with type 2 diabetes
title_full_unstemmed Inverse association between remnant cholesterol and risks of atrial fibrillation among patients with type 2 diabetes
title_short Inverse association between remnant cholesterol and risks of atrial fibrillation among patients with type 2 diabetes
title_sort inverse association between remnant cholesterol and risks of atrial fibrillation among patients with type 2 diabetes
topic atrial fibrillation
type 2 diabetes mellitus
remnant cholesterol
cardiovascular disease
hyperlipidemia
url https://www.frontiersin.org/articles/10.3389/fendo.2025.1461613/full
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