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Brief Communication
Association between cardiac arrhythmia before pregnancy and gestational diabetes: a nationwide population-based study in Korea
You-Jung Choi, Won Young Wi, Geum Joon Cho, Jin Oh Na
Epidemiol Health. 2023;45:e2023103.   Published online December 4, 2023
DOI: https://doi.org/10.4178/epih.e2023103
  • 3,604 View
  • 168 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
Given the higher prevalence of cardiac arrhythmias in individuals with diabetes, we investigated the relationship between cardiac arrhythmias and the incidence of gestational diabetes (GDM). This retrospective cohort study utilized data from the Korean Health Insurance Service database, encompassing 1,113,729 women who gave birth between January 2007 and December 2015. After excluding those who did not undergo National Health Screening tests within 1 year prior to pregnancy, those with multifetal pregnancies, and those diagnosed with diabetes, we analyzed 365,880 singleton pregnancies without a history of diabetes. Of these, 3,253 (0.9%) had cardiac arrhythmias, including premature extra beats, supraventricular tachyarrhythmias, and/or atrial flutter/fibrillation. GDM occurred in 31,938 (8.7%) subjects during pregnancy, and was more prevalent in women with cardiac arrhythmia than in those without (14.9 vs. 8.7%, p<0.001). In the multivariate analysis, the association between cardiac arrhythmia and GDM remained statistically significant (adjusted odds ratio, 1.78; 95% confidence interval, 1.61 to 1.97; p<0.001). Subgroup analysis revealed that the risk of GDM was consistently statistically significant in subjects with cardiac arrhythmia, regardless of age, body mass index, and the presence or absence of chronic hypertension. Therefore, cardiac arrhythmias before and during pregnancy appear to be associated with an increased risk of developing GDM.
Summary
Korean summary
본 연구에서는 부정맥과 임신성 당뇨병의 발생과의 관계를 확인인하기 위하여 2007년부터 2015년까지 국민건강보험 공단 데이터를 이용하여 분만력을 가진 1,113,729명의 여성을 대상으로 진행되었습니다. 최종 분석은 과거 당뇨병 진단병력을 가지고 있는 환자를 제외하고 365,880건의 단태아 임산부를 포함하였고, 전체 대상자 중 31,938 (8.7%)에서 임신성 당뇨병을 확인하였습니다. 그 중 부정맥 병력이 확인되지 않은 임산부와 비교하였을 때, 부정맥 병력이 있는 경우 임신 기간 중 임신성 당뇨병 발생률이 높았으며 (8.7% vs. 14.9%, p<0.001), 다변량 분석에서도 부정맥과 임신 당뇨병 간의 연관성이 통계적으로 유의미하게 나타났습니다 (adjusted odds ratio, 1.78; 95% confidence interval, 1.61 to 1.97; p<0.001). 따라서, 본 연구는 임신 전후의 부정맥 병력은 임신성 당뇨병 발병 위험 증가와 관련 있음을 시사합니다.
Key Message
This nationwide population-based cross-sectional study using the Korean Health Insurance Service database showed that women with a history of cardiac arrhythmia had an elevated risk of incident GDM during pregnancy. The prevalence of GDM was significantly higher in women with cardiac arrhythmias (8.7% vs. 14.9%). There was a statistically significant association between cardiac arrhythmia and GDM (adjusted odds ratio: 1.78), suggesting that cardiac arrhythmias before and during pregnancy are linked to an increased risk of developing GDM, independent of age, BMI, and chronic hypertension.
Original Article
The association between physical activity and atrial fibrillation applying the Heaviside function in survival analysis: the Multi-Ethnic Study of Atherosclerosis
Yaser Mokhayeri, Seyed Saeed Hashemi-Nazari, Mohammad Ali Mansournia, Hamid Soori, Soheila Khodakarim
Epidemiol Health. 2017;39:e2017024.   Published online June 18, 2017
DOI: https://doi.org/10.4178/epih.e2017024
  • 15,173 View
  • 203 Download
  • 6 Web of Science
  • 5 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Although the effect of physical activity (PA) on the incidence of atrial fibrillation (AF) has been studied, contradictory results have been reported. Such discrepancies may reflect the different effects of various types of PA upon AF, as well as gender interactions. Therefore, we aimed to evaluate the associations of PA types (total, moderate/vigorous, and intentional), as well as walking pace, with AF risk in men and women.
METHODS
Using the Multi-Ethnic Study of Atherosclerosis Typical Week Physical Activity Survey, 3 PA measures and walking pace were calculated among 6,487 men and women aged 45-84 years. The incidence of AF over approximately 11 years of followup was ascertained. The association of each PA measure and walking pace with AF incidence was estimated using multivariable Cox proportional hazard models. An extended Cox model with Heaviside functions (hv) of time was used to estimate the effects of time-varying covariates.
RESULTS
During 11 years of follow-up (49,557 person-years), 242 new AF cases occurred. The incidence rate of AF was 48.83 per 10,000 person-years. The proportional hazard (PH) assumption for total PA among women was not met; hence, we used the hv to calculate the hazard ratio. Total PA in women in the hv2 analysis was negatively associated with AF in all 3 models, although for hv1 no significant association was observed. The PH assumption for walking pace among men was not met, and none of the hv showed a statistically significant association between walking pace and AF in men.
CONCLUSIONS
These results suggest that PA is inversely associated with AF in women.
Summary

Citations

Citations to this article as recorded by  
  • Leisure-time and occupational physical activity and risk of cardiovascular disease incidence: a systematic-review and dose-response meta-analysis of prospective cohort studies
    Asma Kazemi, Sepideh Soltani, Dagfinn Aune, Elham Hosseini, Zeinab Mokhtari, Zahra Hassanzadeh, Ahmad Jayedi, Francisco Pitanga, Masoumeh Akhlaghi
    International Journal of Behavioral Nutrition and Physical Activity.2024;[Epub]     CrossRef
  • Impact of ventricular assist device use on pediatric heart transplant waitlist mortality: Analysis of the scientific registry of transplant recipients database
    Arene Butto, Lydia K. Wright, Jameson Dyal, Chad Y. Mao, Richard Garcia, William T. Mahle
    Pediatric Transplantation.2024;[Epub]     CrossRef
  • Weekly physical activity and incident atrial fibrillation in females – A dose-response meta-analysis
    Ioannis Anagnostopoulos, Maria Kousta, Charalampos Kossyvakis, Eleni Lakka, Dimitrios Vrachatis, Spyridon Deftereos, Vassilios P. Vassilikos, Georgios Giannopoulos
    International Journal of Cardiology.2023; 370: 191.     CrossRef
  • Self-Reported Walking Pace and Risk of Cardiovascular Diseases: A Two-Sample Mendelian Randomization Study
    Lu Chen, Xingang Sun, Yuxian He, Liangrong Zheng
    Frontiers in Genetics.2022;[Epub]     CrossRef
  • Sex-Specific Exposure–Effect Relationship Between Physical Activity and Incident Atrial Fibrillation in the General Population: A Dose–Response Meta-Analysis of 16 Prospective Studies
    Qin Wan, Yue Zhou, Wengen Zhu, Xiao Liu
    Frontiers in Cardiovascular Medicine.2021;[Epub]     CrossRef
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