Atrial Fibrillation and Lipid-related Indices in Japanese Men: An Age-matched Case-control Study

<h3>Background/Aim:</h3> Atrial fibrillation (AF) is associated with cardiovascular risk factors. Although certain lipid-related indices, including the ratio of low-density lipoprotein (LDL) cholesterol to high-density lipoprotein (HDL) cholesterol (LDL-C/HDL-C), the ratio of triglycerides to HDL-C (TG/HDL-C), lipid accumulation product (LAP), cardiometabolic index (CMI) and the ratio of gamma-glutamyltransferase to HDL-C (GGT/HDL-C), are known to predict cardiovascular disease, their relationship with AF is unclear. <h3>Patients and Methods:</h3> The participants included 154 men (median of age: 66 years) with AF and 308 age-matched men without AF. Cardiovascular risk factors, including obesity indices, blood pressure, blood lipids and hemoglobin A_1C, as well as lipid-related indices, were compared between the groups with and without AF. <h3>Results:</h3> Body mass index, waist circumference and GGT were significantly higher or larger in participants with AF than in those without AF, while LDL-C was significantly lower in the AF group than in the control group. TG, HDL-C and hemoglobin A_1C were not significantly different between the two groups. LAP and GGT/HDL-C were significantly higher and LDL-C/HDL-C was significantly lower in the AF group than in the control group, whereas TG/HDL-C and CMI were not significantly different between the two groups. Then, a new lipid-related index (AF risk index: AFRI), defined as the product of waist circumference and GGT divided by LDL-C, was proposed and shown to be associated with AF more strongly than each cardiovascular risk factor alone. <h3>Conclusion:</h3> LAP and GGT/HDL-C were positively associated with AF, whereas LDL-C/HDL-C was inversely associated with AF. AFRI may be a useful marker for discriminating the risk of AF.