Improved Proteinuria May Attenuate the Risk of Atrial Fibrillation: A Nationwide Population-Based Cohort Study
Abstract
1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | Total | Groups According to the Change in Proteinuria | ||||
---|---|---|---|---|---|---|
Proteinuria-Free | Proteinuria-Improved | Proteinuria-Progressed | Proteinuria-Persistent | p-Value | ||
Number of participants (%) | 1,708,103 | 1,666,111 (97.54) | 18,759 (1.10) | 20,936 (1.23) | 2297 (0.13) | |
Age, years | 44.0 ± 12.09 | 43.92 ± 12.06 | 47.01 ± 13.19 | 47.01 ± 13.05 | 49.43 ± 12.44 | <0.001 |
Sex | <0.001 | |||||
Male | 1,178,673 (69.00) | 1,150,995 (69.08) | 11,930 (63.6) | 13,943 (66.60) | 1816 (78.48) | |
Female | 529,430 (31.00) | 515,116 (30.92) | 6829 (36.4) | 6993 (33.40) | 498 (21.52) | |
Body mass index (kg/m2) | 23.63 ± 3.03 | 23.61 ± 3.02 | 24.18 ± 3.33 | 24.25 ± 3.45 | 24.89 ± 3.34 | <0.001 |
Household income | <0.001 | |||||
First quartile, lowest | 255,667 (14.97) | 248,768 (14.93) | 3261 (17.38) | 3342 (15.96) | 297 (12.83) | |
Second quartile | 633,817 (37.11) | 619,240 (37.17) | 6613 (35.25) | 7288 (34.81) | 680 (29.39) | |
Third quartile | 564,014 (33.02) | 550,552 (33.04) | 5891 (31.4) | 6763 (32.3) | 815 (35.22) | |
Fourth quartile, highest | 254,605 (14.91) | 247,551 (14.86) | 2994 (15.96) | 3543 (16.92) | 522 (22.56) | |
Smoking status | <0.001 | |||||
Never | 984,134 (57.62) | 958,655 (57.54) | 11,620 (61.94) | 12,625 (60.3) | 1246 (53.85) | |
Former | 212,855 (12.46) | 207,726 (12.47) | 2216 (11.81) | 2546 (12.16) | 370 (15.99) | |
Current | 511,114 (29.92) | 499,730 (29.99) | 4923 (26.24) | 5765 (27.54) | 698 (30.16) | |
Alcohol consumption (days/week) | <0.001 | |||||
<3 | 1,143,895 (66.97) | 1,115,187 (66.93) | 12,972 (69.15) | 14,239 (68.01) | 1512 (65.34) | |
≥3 | 564,208 (33.03) | 550,924 (33.07) | 5787 (30.85) | 6697 (31.99) | 802 (34.66) | |
Regular exercise (days/week) | <0.001 | |||||
<3 | 1,377,901 (80.67) | 1,344,948 (80.72) | 14,564 (77.64) | 16,603 (79.3) | 1800 (77.79) | |
≥3 | 330,202 (19.33) | 321,163 (19.28) | 4195 (22.36) | 4333 (20.7) | 514 (22.21) | |
Comorbidities | ||||||
Hypertension | 773,343 (45.27) | 748,007 (44.9) | 11,062 (58.97) | 12,529 (59.84) | 1762 (76.15) | <0.001 |
Diabetes mellitus | 241,826 (14.16) | 230,155 (13.81) | 4991 (26.61) | 5775 (27.58) | 915 (39.54) | <0.001 |
Dyslipidemia | 423,808 (24.81) | 408,103 (24.49) | 6932 (36.95) | 7674 (36.65) | 1113 (48.1) | <0.001 |
Cancer | 31,617 (1.85) | 30,441 (1.83) | 536 (2.86) | 556 (2.66) | 85 (3.67) | <0.001 |
Renal disease | 17,424 (1.02) | 15,207 (0.91) | 1002 (5.34) | 934 (4.46) | 283 (12.23) | <0.001 |
Charlson Comorbidity Index | ||||||
0 | 677,173 (39.64) | 663,858 (39.84) | 5941 (31.67) | 6762 (32.3) | 612 (26.45) | <0.001 |
1 | 692,943 (40.57) | 677,737 (40.68) | 6794 (36.22) | 7706 (36.81) | 710 (30.68) | <0.001 |
≥2 | 337,987 (19.79) | 324,516 (19.48) | 6024 (32.11) | 6468 (30.89) | 992 (42.87) | <0.001 |
Number of Events | Event Rate (%) | Incidence Rate (Per 1000 Person Years) | Unadjusted | Multivariable Adjusted (1) | Multivariable Adjusted (2) | ||||
---|---|---|---|---|---|---|---|---|---|
HR (95% CI) | p Value | HR (95% CI) | p Value | HR (95% CI) | p Value | ||||
Atrial Fibrillation | 40,654 | 2.38 | 1.68 | ||||||
Proteinuria-Free: 0 → 0 | 38,857 | 2.33 | 1.64 | 1 (Ref) | 1 (Ref) | 1 (Ref) | |||
Proteinuria-Improved | |||||||||
+1 → 0 | 438 | 3.37 | 2.43 | 1.48 (1.35, 1.63) | <0.001 | 1.11 (1.01, 1.22) | 0.035 | 1.10 (1.00, 1.21) | 0.053 |
+2 → 0 | 172 | 4.42 | 3.23 | 1.98 (1.70, 2.29) | <0.001 | 1.43 (1.23, 1.66) | <0.001 | 1.40 (1.21, 1.63) | <0.001 |
+2 → +1 | 41 | 5.66 | 4.25 | 2.63 (1.93, 3.57) | <0.001 | 1.59 (1.17, 2.16) | 0.003 | 1.56 (1.15, 2.12) | 0.004 |
+3~4 → 0 | 43 | 5.49 | 4.15 | 2.55 (1.89, 3.44) | <0.001 | 1.83 (1.36, 2.47) | <0.001 | 1.80 (1.33, 2.42) | <0.001 |
+3~4 → +1 | 10 | 5.65 | 4.59 | 2.87 (1.54, 5.33) | 0.009 | 1.54 (1.03, 2.04) | 0.017 | 1.53 (1.02, 2.04) | 0.0191 |
+3~4 → +2 | 18 | 9.09 | 7.34 | 4.59 (2.89, 7.29) | <0.001 | 2.53 (1.59, 4.02) | <0.001 | 2.48 (1.56, 3.93) | 0.001 |
Proteinuria-Progressed | |||||||||
0 → +1 | 566 | 4 | 2.91 | 1.78 (1.63, 1.93) | <0.001 | 1.36 (1.26, 1.48) | <0.001 | 1.36 (1.25, 1.47) | <0.001 |
0 → +2 | 238 | 5.21 | 3.87 | 2.38 (2.09, 2.70) | <0.001 | 1.64 (1.44, 1.86) | <0.001 | 1.62 (1.43, 1.84) | <0.001 |
0 → +3~4 | 55 | 5.73 | 4.35 | 2.69 (2.06, 3.50) | <0.001 | 2.07 (1.59, 2.69) | <0.001 | 2.06 (1.58, 2.68) | <0.001 |
+1 → +2 | 46 | 5.91 | 4.46 | 2.74 (2.06, 3.66) | <0.001 | 1.45 (1.09, 1.94) | 0.011 | 1.44 (1.08, 1.93) | 0.013 |
+1 → +3~4 | 17 | 8.59 | 6.93 | 4.33 (2.69, 6.96) | <0.001 | 2.37 (1.48, 3.82) | 0.004 | 2.32 (1.44, 3.74) | 0.005 |
+2 → +3~4 | 16 | 6.08 | 4.71 | 2.92 (1.79, 4.77) | <0.001 | 1.80 (1.10, 2.93) | 0.019 | 1.75 (1.07, 2.86) | 0.024 |
Proteinuria-Persistent | |||||||||
+1 → +1 | 81 | 5.45 | 4.05 | 2.49 (2.01, 3.1) | <0.001 | 1.45 (1.17, 1.8) | 0.008 | 1.43 (1.15, 1.78) | 0.001 |
+2 → +2 | 43 | 6.21 | 4.78 | 2.96 (2.20, 3.99) | <0.001 | 1.65 (1.23, 2.23) | 0.001 | 1.64 (1.22, 2.22) | 0.001 |
+3~4 → +3~4 | 13 | 10.83 | 9.18 | 5.79 (3.36, 9.96) | <0.001 | 3.53 (2.05, 6.08) | <0.001 | 3.47 (2.01, 5.97) | <0.001 |
Status of Proteinuria | Multivariable Adjusted | |
---|---|---|
HR (95% CI) | p Value | |
Improved vs. Free (reference) | 1.233 (1.142, 1.333) | <0.001 |
Progressed vs. Free (reference) | 1.474 (1.383, 1.575) | <0.001 |
Persistent vs. Free (reference) | 1.595 (1.345, 1.886) | <0.001 |
Improved vs. Persistent (reference) | 0.804 (0.673, 0.974) | 0.019 |
Progressed vs. Persistent (reference) | 0.947 (0.786, 1.126) | 0.466 |
Improved vs. Progressed (reference) | 0.847 (0.767, 0.938) | 0.005 |
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Chang, Y.; Kang, M.K.; Song, T.-J. Improved Proteinuria May Attenuate the Risk of Atrial Fibrillation: A Nationwide Population-Based Cohort Study. J. Clin. Med. 2024, 13, 4648. https://doi.org/10.3390/jcm13164648
Chang Y, Kang MK, Song T-J. Improved Proteinuria May Attenuate the Risk of Atrial Fibrillation: A Nationwide Population-Based Cohort Study. Journal of Clinical Medicine. 2024; 13(16):4648. https://doi.org/10.3390/jcm13164648
Chicago/Turabian StyleChang, Yoonkyung, Min Kyoung Kang, and Tae-Jin Song. 2024. "Improved Proteinuria May Attenuate the Risk of Atrial Fibrillation: A Nationwide Population-Based Cohort Study" Journal of Clinical Medicine 13, no. 16: 4648. https://doi.org/10.3390/jcm13164648
APA StyleChang, Y., Kang, M. K., & Song, T.-J. (2024). Improved Proteinuria May Attenuate the Risk of Atrial Fibrillation: A Nationwide Population-Based Cohort Study. Journal of Clinical Medicine, 13(16), 4648. https://doi.org/10.3390/jcm13164648