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      Relationship Between Serum Albumin and Risk of Atrial Fibrillation: A Dose-Response Meta-Analysis

      systematic-review

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          Abstract

          Background: The dose–response association between serum albumin and atrial fibrillation is not well known. This study aims to assess the relationship between albumin and atrial fibrillation and the potential dose–response effect.

          Methods: Studies reported that the serum albumin and AF were identified by searching the EMBASE, PubMed, and Cochrane Library databases. The potential dose–response effect was performed by using a stage robust error meta-regression.

          Results: Nine studies were included with a total of 32,130 individuals. Patients with high albumin level were associated with a decreased risk of atrial fibrillation compared with patients with low serum albumin (OR[odds ratio]: 0.62, 95% CI [0.44, 0.89]; I 2 = 76%; P = 0.009). In the dose–response analysis, for each 10 g/L increase in serum albumin level, the risk of atrial fibrillation decreased by 36% (95% CI: 0.51–0.81, I 2 = 87%, P < 0.001). Furthermore, a significant negative linear relationship between serum albumin and the risk of atrial fibrillation ( P nonlinearity = 0.33) was found.

          Conclusion: Our dose–response meta-analysis suggests that low serum albumin level is associated with an increased risk of atrial fibrillation. Further studies are needed to explore the effect of induction of elevated serum albumin levels on the prevention of atrial fibrillation.

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          The PRISMA 2020 statement: an updated guideline for reporting systematic reviews

          Matthew J L Page, Joanne E McKenzie, Patrick Bossuyt … (2024)
          The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, published in 2009, was designed to help systematic reviewers transparently report why the review was done, what the authors did, and what they found. Over the past decade, advances in systematic review methodology and terminology have necessitated an update to the guideline. The PRISMA 2020 statement replaces the 2009 statement and includes new reporting guidance that reflects advances in methods to identify, select, appraise, and synthesise studies. The structure and presentation of the items have been modified to facilitate implementation. In this article, we present the PRISMA 2020 27-item checklist, an expanded checklist that details reporting recommendations for each item, the PRISMA 2020 abstract checklist, and the revised flow diagrams for original and updated reviews.
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            Inflammation and the pathogenesis of atrial fibrillation.

            Yu-Feng Hu, Yi-Jen Chen, Yenn-Jiang Lin … (2015)
            Atrial fibrillation (AF) is the most common cardiac arrhythmia. However, the development of preventative therapies for AF has been disappointing. The infiltration of immune cells and proteins that mediate the inflammatory response in cardiac tissue and circulatory processes is associated with AF. Furthermore, the presence of inflammation in the heart or systemic circulation can predict the onset of AF and recurrence in the general population, as well as in patients after cardiac surgery, cardioversion, and catheter ablation. Mediators of the inflammatory response can alter atrial electrophysiology and structural substrates, thereby leading to increased vulnerability to AF. Inflammation also modulates calcium homeostasis and connexins, which are associated with triggers of AF and heterogeneous atrial conduction. Myolysis, cardiomyocyte apoptosis, and the activation of fibrotic pathways via fibroblasts, transforming growth factor-β and matrix metalloproteases are also mediated by inflammatory pathways, which can all contribute to structural remodelling of the atria. The development of thromboembolism, a detrimental complication of AF, is also associated with inflammatory activity. Understanding the complex pathophysiological processes and dynamic changes of AF-associated inflammation might help to identify specific anti-inflammatory strategies for the prevention of AF.
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              Methods for trend estimation from summarized dose-response data, with applications to meta-analysis.

              Sander Greenland, Matthew Longnecker (1992)
              Meta-analysis often requires pooling of correlated estimates to compute regression slopes (trends) across different exposure or treatment levels. The authors propose two methods that account for the correlations but require only the summary estimates and marginal data from the studies. These methods provide more efficient estimates of regression slope, more accurate variance estimates, and more valid heterogeneity tests than those previously available. One method also allows estimation of nonlinear trend components, such as quadratic effects. The authors illustrate these methods in a meta-analysis of alcohol use and breast cancer.
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                Author and article information

                Contributors
                Journal
                Journal ID (nlm-ta): Front Nutr
                Journal ID (iso-abbrev): Front Nutr
                Journal ID (publisher-id): Front. Nutr.
                Title: Frontiers in Nutrition
                Publisher: Frontiers Media S.A.
                ISSN (Electronic): 2296-861X
                Publication date (Electronic): 18 August 2021
                Publication date Collection: 2021
                Volume: 8
                Electronic Location Identifier: 728353
                Affiliations
                [1] 1Department of Pathology, The Affiliated Stomatological Hospital of Nanchang University , Nanchang, China
                [2] 2Department of General Surgery, The First Affiliated Hospital of Nanchang University , Nanchang, China
                [3] 3Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University , Guangzhou, China
                [4] 4Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University , Guangzhou, China
                Author notes

                Edited by: Lilia Castillo-Martinez, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico

                Reviewed by: Dulce González, Instituto Nacional de Enfermedades Respiratorias-México (INER), Mexico; María Fernanda Bernal, National Autonomous University of Mexico, Mexico

                *Correspondence: Jinfeng Tan tantan138@ 123456163.com

                This article was submitted to Clinical Nutrition, a section of the journal Frontiers in Nutrition

                Article
                DOI: 10.3389/fnut.2021.728353
                PMC ID: 8418186
                PubMed ID: 34490334
                SO-VID: 1e56a4a0-b74b-482b-aebf-35eb59543e57
                Copyright © Copyright © 2021 Wang, Du, Xiao, Li, Liu, Tan and Zhang.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                Date received : 21 June 2021
                Date accepted : 23 July 2021
                Page count
                Figures: 4, Tables: 2, Equations: 0, References: 32, Pages: 9, Words: 4796
                Categories
                Subject: Nutrition
                Subject: Systematic Review

                Keywords: atrial fibrillation,dose-response,risk factor,nutrition,albumin
                Data availability:
                Keywords: atrial fibrillation, dose-response, risk factor, nutrition, albumin

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