Are adipokines associated with atrial fibrillation in type 2 diabetes

Introduction: The potential effect of adipokines on the development of AF is yet to be established. The aim of this study was to investigate the association of baseline serum adipokines with 1) presence of AF at baseline, 2) future risk of AF development. Materials and Methods: The current study is a subanalysis of the prospective, randomized AVOCADO (Aspirin Vs/Or Clopidogrel in Aspirin-resistant Diabetics inflammation Outcomes) trial. The AVOCADO study included patients with type 2 DM burdened with at least 2 additional cardiovascular risk factors and receiving acetylsalicylic acid. In patients included in the current analysis adipokines and inflammatory biomarkers levels were measured. Information on the subsequent AF diagnosis was collected after a median of 5.4-year follow-up. Results: A total of 273 patients with type 2 DM (median age: 68 years, 52% male) were included to the initial analysis comparing patients with and without AF at baseline. Patients with diagnosed AF (12%) had higher levels of serum resistin (8.5[5.8-10.5] vs 6.9[5.6-8.7]ng/ml; p=0.034), adiponectin (6.9[5.6-8.7] vs 2.7[1.8-4.2]ng/ml; p=0.032), and N-terminal pro-B-type natriuretic peptide (336[148-473] vs 108[45-217]; p<0.001) than non-AF patients. There were no significant differences in serum leptin, IL-6 and TNF-α concentrations between the two groups. From subjects without known AF at study entry, 19% developed AF at follow-up. In logistic regression analysis, baseline adipokines' levels did not predict AF development. Conclusion: In type 2 DM, patients with AF have higher resistin and adiponectin concentrations than patients with no AF. None of the studied adipokines proved a predictor of future AF development.