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Assessing causal relationship between non-alcoholic fatty liver disease and risk of atrial fibrillation

  • Author Footnotes
    # These authors contributed equally to the study and are joint first authors.
    Ziang Li
    Footnotes
    # These authors contributed equally to the study and are joint first authors.
    Affiliations
    State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100037, People’s Republic of China
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  • Author Footnotes
    # These authors contributed equally to the study and are joint first authors.
    Bin Zhang
    Footnotes
    # These authors contributed equally to the study and are joint first authors.
    Affiliations
    State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100037, People’s Republic of China
    Search for articles by this author
  • Jinyue Li
    Affiliations
    Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
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  • Zhihang Tao
    Affiliations
    State Key Laboratory for Oncogenes and Related Genes, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Division of Gastroenterology and Hepatology, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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  • Yongjian Wu
    Correspondence
    Corresponding author. Address: Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, No.167 Beilishi Road, Beijing 100037, China; Tel.: +86 137 0138 7189, fax: +86 10-88396780.
    Affiliations
    State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100037, People’s Republic of China
    Search for articles by this author
  • Author Footnotes
    # These authors contributed equally to the study and are joint first authors.
Published:November 09, 2022DOI:https://doi.org/10.1016/j.jhep.2022.10.032
      Non-alcoholic fatty liver disease (NAFLD) and atrial fibrillation (AF) have become the most prevalent diseases in the fields of chronic liver disease and sustained cardiac arrhythmia, respectively, which attract significant interest due to their affiliated morbidity and increased mortality.
      • Chen Z.
      • Liu J.
      • Zhou F.
      • Li H.
      • Zhang X.J.
      • She Z.G.
      • et al.
      Nonalcoholic fatty liver disease: an emerging driver of cardiac arrhythmia.
      Epidemiological evidence suggests that NAFLD may increase the risk of AF.
      • Alon L.
      • Corica B.
      • Raparelli V.
      • Cangemi R.
      • Basili S.
      • Proietti M.
      • et al.
      Risk of cardiovascular events in patients with non-alcoholic fatty liver disease: a systematic review and meta-analysis.
      The findings, however, were not completely consistent. In a large prospective cohort, Van Kleef et al. discovered that fatty liver disease was not related to prevalent or incident AF.
      • van Kleef L.A.
      • Lu Z.
      • Arfan Ikram M.
      • de Groot N.M.S.
      • Kavousi M.
      • de Knegt R.J.
      Liver stiffness not fatty liver disease is associated with atrial fibrillation: the Rotterdam study.
      Observational studies have methodological constraints and are inevitably subject to residual confounding factors. It is still uncertain if NAFLD is a causal factor in AF.

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