The association between non-alcoholic fatty liver disease and atrial fibrillation: A meta-analysis

Abstract

Background/objectives: The association between non-alcoholic fatty liver disease (NAFLD) and atrial fibrillation (AF) has been suggested by recent epidemiological studies although the results were inconsistent. This meta-analysis was conducted to summarize all available data.

Methods: A comprehensive literature review was conducted using MEDLINE and EMBASE database through May 2017 to identify all studies that reported the risk of AF among patients with NAFLD versus those without NAFLD. Effect estimates from each study were extracted and combined together using the random-effect, generic inverse variance method of DerSimonian and Laird.

Results: Of 1009 studies, 5 studies (two cross-sectional studies and three cohort studies) with 238,129 participants met the eligibility criteria and were included in the meta-analysis. The risk of AF in patients with NAFLD was significantly higher than subjects without NAFLD with the pooled risks ratio of 2.06 (95% confidence interval, 1.10-3.85). The statistical heterogeneity was high with an I² of 78%, which was the major limitation of this meta-analysis.

Conclusions: A significantly increased risk of AF among patients with NAFLD was demonstrated in this study.

Keywords: Atrial arrhythmia; Atrial fibrillation; Meta-analysis; Non-alcoholic fatty liver disease; Non-alcoholic steatohepatitis.